July 8, 2016 Destin, FL

1 1 Table of Contents

General Assembly – July 8, 2016 – Destin, FL

Table of Contents 2 Notice of Meeting 4 Official Announcement 5 General Assembly Agenda 6 Schedule of Official Activities 9 Hotel Floor Plan 10 Organizational Chart 11 LAFP District Map 12 Instructions to Members of the General Assembly 13 Standing Rules of the General Assembly 15 Principal Rules Governing Motions 18 Necrology Report 19 Member Anniversaries 20 Current LAFP Officers 21 Guest Speaker – Rob Muscalus, DO – Blue Cross Blue Shield Louisiana 22 Guest Speaker – Dan Claitor, JD – LA State Senator 23 Guest Speaker – Robert Wergin, MD – AAFP Board Chair 24 Unfinished Business 25 New Business 26 Follow-Up Actions Taken on Resolutions from 2015 General Assembly 27 Approval of Minutes – 2015 General Assembly Meeting 30 Resolutions and Late Resolutions Resolution 1: Dues Increase for Active, Inactive and Supporting Membership 41 Resolution 2: Division of the Legislative and Membership Issues Committee 43 Past Presidents 44 Committee Members 46 Executive Vice President Report 48 Report of Officers Speaker Report/Address 52 Vice-Speaker Report/Address 53 President Report/Address 54 President-Elect Report/Address 55 Secretary Report/Address 57 Treasurer Report/Address 60 AAFP Delegates Report/Address 62 Committee Reports: Committee on Resident and Student Leadership 64 Committee on Education 66 Committee on Legislative & Membership Issues Legislative Report 68 Membership Report 84 Committee on Operations 96 2015 Financials 99 2016 Current Financials 104 Current Account Holdings 109 Nominating Committee Report 110 Family Medicine Medical School and Match Data Report 112 2 Table of Contents, continued

General Assembly – July 8, 2016 – Destin, FL

Call for Nominations of LAFP and Officers and Board of Directors 116 Call for Nominations of LAFP Foundation Officers and Board of Directors 117 LAFP District Director Reports 118 Family Medicine Department Reports LSU – New Orleans 119 LSU - Shreveport 121 Tulane 122 Family Medicine Residency Program Director Reports Alexandria Program 126 Baton Rouge General Program 127 Bogalusa Program 129 East Jefferson Program 131 Kenner Program 133 Lafayette Program 134 Lake Charles Program 136 Monroe Program 137 Shreveport/EM/Vivian Program 138 LAFP Foundation President’s Report 140 2016 Family Medicine Award Winners 142 LaFamPac Report 144 LAFP Bylaws 146

NOTICE: This handbook is published for information of the members of the General Assembly. The reports, as published, are preliminary reports and are subject to necessary changes. They will be official only after they, or some modification or substitute for them, have been presented and enacted upon by the 2016 LAFP General Assembly. Unauthorized quotation from the material appearing herein is prohibited.

3 Notice of Meeting

General Assembly – July 8, 2016 – Destin, FL

NOTICE: This handbook is published for the information of the members of the LAFP General Assembly. The reports, as published, are preliminary reports and are subject to necessary changes. They will be official only after they, or some modification or substitute for them, have been presented to the General Assembly. Unauthorized quotation from the material appearing herein is prohibited.

Reports included are from Officers, Committees, Members of the General Assembly, Official Order of Business, Resolutions and Instructions to members attending.

Mission Statement (From the LAFP Strategic Plan)

The Mission of the Louisiana Academy of Family Physicians is to promote and support Louisiana's family physicians in providing excellent health care, service and leadership.

4 Official Announcement

General Assembly – July 8, 2016 – Destin, FL

Official Announcement General Assembly to Meet in Destin, FL July 8, 2016 The 2016 LAFP General Assembly will meet Friday, July 8, 2016, in the Magnolia Ballroom of the Baytowne Conference Center in Destin, FL. The Assembly will convene in conjunction with the LAFP Annual Assembly and Exhibition, which will meet July 7-10, 2016 at the Sandestin Golf and Beach Resort.

During the meeting, members will have the opportunity to share their views and help shape new LAFP policies. The members will elect LAFP officers and members to the LAFP Board of Directors on July 8, 2016. Further information about the 2016 General Assembly is available online at http://www.lafp.org, including links to:

 a tentative schedule of official activities,  housing and registration information, and  a list of resolutions submitted to date.

Among resolution topics to be considered:  Resolution 1: Separation of Legislative and Membership Issues Committee  Resolution 2: Dues Increase for Active, Inactive and Supporting Membership

5 General Assembly Agenda

General Assembly – July 8, 2016 – Destin, FL

I. Call to Order by the Speaker – Derek Anderson, MD A. Invocation B. Pledge of Allegiance C. In Memoriam Report D. Member Anniversaries E. Introduction of Board of Directors

II. Introduction of Guest Speakers – Derek Anderson, MD A. Address from Blue Cross Blue Shield of LA – Rob Muscalus, DO B. Address from LA State Senator – Dan Claitor, JD C. Address from AAFP President – Robert Wergin, MD, FAAFP

III. Unfinished Business

IV. New Business A. Follow Up Actions Taken From 2015 General Assembly B. Approval of Minutes of the 2015 General Assembly Meeting C. Introduction of Resolutions and Late Resolutions (Note: All resolutions submitted to the Executive Vice President thirty or more days preceding this meeting pursuant to the Bylaws, are contained in the Handbook. Additional resolutions may be submitted at this session only after an affirmative vote of two-thirds of the members present and voting. Resolutions received subsequent to the thirty- day period, will be distributed separately. Members wishing to present resolutions not included in the handbook shall state their desire to the Speaker one hour prior to the opening of the General Assembly.)

V. Introduction of Past Presidents

VI. Introduction of Committee Members

VII. Report of Executive Vice President – Ragan LeBlanc

VIII. Reports of Officers A. Address of Speaker – Derek Anderson, MD B. Address of the Vice Speaker – Dan Jens, MD C. Address of the President – Brian Elkins, MD D. President-Elect – James Taylor, MD E. Secretary –Christopher Foret, MD F. Treasurer – Bryan Picou, MD G. AAFP Delegate Reports – Russell Roberts, MD; Marguerite Picou, MD

IX. Reports of Committees A. Committee on Resident and Student Leadership B. Committee on Education Report – Tobe Momah, MD C. Committee on Legislative & Membership Issues Report – James A. Taylor, Jr., MD D. Committee on Operations Report – Bryan Picou, MD 1. LAFP Financials a. Review of 2015 Financials b. Review of Current 2016 Financials c. Current Account Holdings E. Nominating Committee Report – James A. Taylor, Jr., MD 6 General Assembly Agenda, continued

General Assembly – July 8, 2016 – Destin, FL

F. Medical School and Match Data Report

X. Call for Nominations of LAFP Officers and Board of Directors

XI. Call for Nominations of LAFP Foundation Officers and Board of Directors

XII. District Director/Alternate Reports A. District 1 –Mary Coleman, MD; Vacant B. District 2 – Daniel Jens, MD; Luis Arencibia, MD C. District 3A –Jack Heidenreich, MD; Camille Pitre, MD D. District 3B – Indira Gautam, MD; Zeb Stearns, MD E. District 4 – Ricky Jones, MD; Gregory Bell, MD F. District 5 –Tobe Mamah, MD; James Smith, MD G. District 6A – Phillip Ehlers, MD; Carol Smothers, MD H. District 6B – Richard Bridges, MD; Keisha Harvey, MD I. District 7 – Jason Fuqua, MD; Andrew Davies, MD J. District 8 – Jonathan Hunter, MD; Matthew Erickson, MD K. District Director at Large – Jody George, MD; Esther Holloway, MD XIII. Family Medicine Department Reports A. LSU – New Orleans, Mary Coleman, MD B. LSU – Shreveport, Michael Harper, MD C. Tulane – Edwin Dennard, MD XIV. Family Medicine Residency Program Director Reports A. Alexandria – Robert Moore, MD B. Baton Rouge – Brian Harrell, MD C. Bogalusa – Emilio Russo, MD D. East Jefferson – Victor Weaver, MD E. Kenner - James Campbell, MD F. Lafayette – Amanda Phillips-Savoy, MD G. Lake Charles - Alan LeBato, MD H. Monroe - Euil Eugene Luther, MD I. Shreveport – Luke Baudoin, MD J. Vivian – Luke Baudoin, MD

XV. LAFP Foundation A. President’s Report – Melvin Bourgeois, MD B. 2016 Family Medicine Award Winners XVI. LaFamPac Report – Marguerite “Cissy” Picou, MD – President

XVII. Election Results – LAFP Officers and Board of Directors A. President-Elect B. Vice-President C. Secretary D. Treasurer E. Speaker of General Assembly F. Vice-Speaker of General Assembly G. AAFP Delegate H. AAFP Alternate Delegate 7 General Assembly Agenda, continued

General Assembly – July 8, 2016 – Destin, FL

I. District 1 Director/Alternate J. District 4 Director/Alternate K. District 5 Director/Alternate L. District 6B Director/Alternate M. District 7 Director/Alternate N. District 8 Director/Alternate O. District Director at Large P. Resident Director/Alternate Q. Student Director/Alternate XVIII. Election Results – LAFP Foundation A. President B. President-Elect C. Secretary D. Treasurer E. Lay Members – (5) F. LAFP Members (4)

XIX. Additional New Business

XX. Announcements

XXI. Adjournment

8 2016 Schedule of Official Activities

General Assembly – July 8, 2016 – Destin, FL

Schedule of Events Friday, July 8, 2016

12:45 – 1:00 pm Lunch Magnolia Ballroom

1:00 pm General Assembly Opens/Call to Order Magnolia Ballroom Invocation Pledge of Allegiance Necrology Report Member Anniversaries Introduction of Current LAFP Officers

1:10 pm Report of Credentials Magnolia Ballroom

1:15 pm Address of Guest Speakers Magnolia Ballroom Rob Muscalus, DO, Blue Cross Blue Shield of LA Dan Claitor, JD, LA State Senator Robert Wergin, MD, AAFP Board Chair

2:00 pm New Business Magnolia Ballroom Follow Up Actions/2015 GA Minutes Board of Directors Reports Introduction of Resolutions and Late Resolutions

2:30 pm Introduction of Past Presidents Magnolia Ballroom Introduction of Committee Members

2:40 pm Report of Executive Vice President Magnolia Ballroom Reports of Officers

3:00 pm Reports of Committees Magnolia Ballroom

3:15 pm Call for Nominations Magnolia Ballroom

3:20 pm District Directors Reports Magnolia Ballroom Family Medicine Department Chair Reports Residency Program Reports

3:25 pm LAFP Foundation Report Magnolia Ballroom

3:30 pm LaFamPac Report Magnolia Ballroom

3:35 pm Elections and Election Results Magnolia Ballroom

3:40 pm Announcements from floor Magnolia Ballroom

3:45 pm Adjournment Magnolia Ballroom

9 Hotel Floor Plan

General Assembly – July 8, 2016 – Destin, FL

10 Organizational Chart

General Assembly – July 8, 2016 – Destin, FL

ORGANIZATIONAL CHART

POLICY IMPLEMENTATION

MEMBERSHIP

SPEAKER/VICE SPEAKER GENERAL ASSEMBLY

OFFICERS Voting - SECRETARY President President-Elect Vice President BOARD OF DIRECTORS Secretary TREASURER Treasurer Speaker Vice Speaker Immediate Past EXECUTIVE VICE PRESIDENT AND President STAFF District Directors (10) Alternate Directors (10) At Large Director/Alt/ At EXECUTIVE COMMITTEE Large Director President AAFP Delegates (2) President-Elect Alternate Delegates (2) Vice President Resident Representative Secretary Student Representative Treasurer Immediate Past President

Non-Voting - Executive Vice President

President (Board Chair)

COMMITTEES Committee on Education Committee on Operations Committee on Legislative & Membership Issues Committee on Nominations Committee on Resident and

11 Student Leadership District Map

General Assembly – July 8, 2016 – Destin, FL

DISTRICT MAP

DISTRICT 1 DISTRICT 3B DISTRICT 5 DISTRICT 6A DISTRICT 7 Orleans Evangeline Caldwell Ascension Acadia St. Bernard Iberia East Carroll E. Baton Rouge Allen Lafayette West Carroll W. Baton Rouge Beauregard DISTRICT 2 St. Landry Catahoula E. Feliciana Calcasieu Jefferson St. Martin Concordia W. Feliciana Cameron Plaquemines Vermillion Franklin Iberville Jefferson Davis St. Charles Jackson Livingston St. James DISTRICT 4 Lincoln Pointe Coupee DISTRICT 8 St. John Bienville Madison Avoyelles Bossier Morehouse DISTRICT 6B Grant DISTRICT 3A Caddo Ouachita St. Helena Lasalle Assumption Claiborne Richland St. Tammany Natchitoches Lafourche DeSoto Tensas Tangipahoa Rapides St. Mary Red River Union Washington Sabine Terrebonne Webster Vernon Winn

12 Instructions to Members of the General Assembly

General Assembly – July 8, 2016 – Destin, FL

(1) The General Assembly establishes policies and defines basic principles through the adoption of reports and resolutions at the time of its annual meeting. As a member of the General Assembly, you are charged with a most important responsibility. It is your responsibility to see that the business of the General Assembly of the Louisiana Academy of Family Physicians is conducted in a manner that will best serve the interests of the State of Louisiana and the entire medical profession, as well as the Academy membership.

(2) Under the terms of its corporate charter and Bylaws, the Louisiana Academy of Family Physicians is governed by a General Assembly representing the members, as well as family medicine residents and students. The members elect a Board of Directors which, in turn, has full power and authority to conduct the Academy's affairs during the interim between the meetings of the Assembly.

Registration and Presentation of Credentials (3) Your first official responsibility as a member is to register and have your credentials certified by signing in on the membership roster. It is important that you register early as the General Assembly is scheduled to begin at 1:00 p.m. on Friday, July 8, 2016 at the Baytowne Conference Center. A registration area for this purpose will be set up. Your badge will have been prepared for you onsite. Registration will be open Thursday, July 7, from 7:00 a.m. to 2:15 p.m., and again on Friday, July 8 at 7:00 a.m. to 12:30 p.m.

Seating in the General Assembly (4) On acceptance of your credentials, your name will be placed on the roll of the General Assembly and remain until final adjournment of the meeting.

(5) The General Assembly is set up in class-room fashion with tables for each member type arranged specifically by the Speaker of the General Assembly. To facilitate the work of the Assembly you are expected to occupy the same seat you take for the entire meeting.

Actions of Previous General Assembly (6) The proceedings (minutes) of the 2015 General Assembly were placed on the LAFP website shortly after the conclusion of the meeting with the placement of any reports including notations of the Assembly action.

(7) In an effort to be fiscally and environmentally responsible, there are no printed copies of the minutes. Resolutions may have citations from any transaction referring to previous actions by the GA on respective subjects. A file of minutes for the previous 10 years is available at the LAFP Office or online at http://www.lafp.org/. Familiarize yourself with the LAFP Bylaws, a copy of which is included in the General Assembly Handbook.

Order of Business (8) The general order of business of the 2016 General Assembly appears in the Agenda & Instructions section of this Handbook.

Voting in the General Assembly (9) Section 6 of Article VII of the Bylaws provides: “Privileges of the floor and the right to vote and hold office in each class of membership shall be the same as provided in that class of membership” located in Chapter IV of the Bylaws. If the Speaker calls for a standing vote or show of hands, the tellers will be asked to make the count. Please, therefore, keep your hand up, or remain standing, until the Speaker requests you to lower your hand or be seated.

13 Instructions to Members of the General Assembly, continued

General Assembly – July 8, 2016 – Destin, FL

(10) When a secret ballot is taken, the Speaker will utilize a paper ballot that will be counted by the tellers chosen by the Speaker.

Presentation of Resolutions (11) Section 7 of Article VII of the Bylaws states that resolutions shall be submitted in writing to the Executive Vice President or the Speaker of the General Assembly at least thirty (30) days prior to the meeting at which they are to be acted upon. Any resolution not meeting the 30 day deadline is considered late. Instructions on the presentation of resolutions are detailed in Rules 7 and 8 of the Standing Rules of the General Assembly which are included in your Handbook.

Privilege of the Floor (12) If you wish to speak during a meeting of the General Assembly and you have been recognized by the Speaker, go to the nearest microphone and identify yourself. Please state clearly your name, what type of member you are and if you represent the Board of Directors or a Standing Committee. This is essential so that the official reporter can make an accurate transcript of the proceedings.

14 Standing Rules of the General Assembly

General Assembly – July 8, 2016 – Destin, FL

STANDING RULES OF THE GENERAL ASSEMBLY The Standing Rules of the Assembly read as follows:

1. The General Assembly will convene, at a time and place to be determined by the Speaker. Admission to the General Assembly shall be limited to those who display a badge issued by the Louisiana Academy of Family Physicians (LAFP).

2. The order of business shall be that as outlined behind the Table of Contents of the Handbook and may be changed by the Speaker of the General Assembly, without deleting any items, in those instances where the business of the Assembly would be expedited by doing so.

3. The American Institute of Parliamentarians Standard Code of Parliamentary Procedure (TSC), most current edition, shall govern the Assembly except when it is in conflict with the Bylaws or the Standing Rules of the General Assembly.

4. Since all committees are standing committees of the Board of Directors, it is the policy of the Assembly that all reports of committees shall be submitted to the Board of Directors before being presented to the General Assembly.

5. The Speaker will provide each member with a list of the reports and resolutions contained in the General Assembly' Handbook.

6. Each address or report is to be presented as expeditiously as possible. The addresses or reports of the following officers shall be limited to twenty minutes: the president; the address of the president-elect shall be limited to fifteen minutes. The address of the Speaker shall be limited to ten minutes. If an officer or committee has additional material to present, it is recommended that it be submitted in writing to the members in order to expedite the work of the Assembly.

7. Pursuant to Section 7 of Chapter VII of the Bylaws, resolutions to be submitted to the General Assembly should be submitted to the Executive Vice President of the Academy or the Speaker of the General Assembly at least thirty days (30) prior to the meeting during which they are to be considered.

All resolutions so submitted will be included in the General Assembly Handbook. Resolutions not submitted thirty days in advance may be introduced under Agenda Item IV in the Assembly only with approval of two- thirds of the Assembly present and voting. Such resolutions should be submitted in the official form, and a copy of the resolution must be given to the Speaker of the Assembly, prior to introduction. Resolutions not properly prepared cannot be accepted. Only resolutions received before the deadline will contain staff-produced background information.

Notwithstanding Rule 9 below, during the opening of the General Assembly, at a time specified by the speaker, any member may present in writing any late resolution(s) pertinent to the objectives of the LAFP or in relation to any report of any officer or committee of the LAFP. Any resolution not previously submitted prior to the 30-day deadline must be electronically communicated to the Speaker no later than one hour prior to the start of the General Assembly.

15 Standing Rules of the General Assembly, continued

General Assembly – July 8, 2016 – Destin, FL

8. Resolutions presented to the Assembly for its consideration by the Assembly will be received from members in good standing, any LAFP standing committee and the Board of Directors.

9. Any member introducing a late resolution at the specified time during the opening of the General Assembly shall be given privilege of the floor. The member introducing the late resolution(s) must state how the late resolution is pertinent as described above. If the late resolution is not deemed pertinent it may not be allowed, unless of exigent nature.

10. When the introduction of late or special resolutions is in order, their order of call will be at the discretion of the presiding officer. After being recognized by the presiding officer, the member shall read the late resolution, the "Whereas" paragraphs are omitted and only the "Resolved" portion presented. The presiding officer may then ask the member how the late resolution is pertinent as described above. The Speaker will inquire of the Assembly if there is any objection. If there is none, the Speaker will instruct the member to proceed. If objection is voiced, the Speaker will call for a vote on the motion to introduce the resolution. If two-thirds of the members present and voting vote in the affirmative, the Speaker will instruct the member to proceed.

11. Any substitute resolution offered from the floor by an individual during debate must be in writing and in good form to be accepted by the Speaker.

12. No member may speak a second time during the discussion of any motion until all members have been given an opportunity to speak once. This will give every member of the Assembly the opportunity to present his or her views.

13. Any LAFP Academy member has the privilege of speaking on any resolution. The presiding officer also may request nonmembers to provide needed information to clarify or present essential facts on an item under discussion. Otherwise, nonmembers will be granted the floor only upon permission of the speaker, vice speaker or committee chair.

14. The nominating procedure for the offices of President-Elect, Vice President, Secretary, Speaker, Vice Speaker, and vacancies on the Board of Directors shall be as follows:

(a) All nominations for positions elected during the General Assembly shall be submitted in writing to the Executive Vice President.

(b) (b)Names of announced candidates for the offices of President-Elect, Vice President, Secretary, Speaker, Vice Speaker, and vacancies on the Board of Directors will be placed in nomination at the opening of the General Assembly with the floor being open for additional nominations at that time.

(c) Names only of the announced candidates will be read before the Assembly. Should an additional nomination or nominations from the floor occur, the candidate or candidates being nominated from the floor shall have the opportunity at the time of nomination to distribute the same information to the General Assembly as has been distributed by those candidates who announced their candidacy prior to the meeting of the General Assembly.

15. Voting and the process for election of officers shall be as follows: 1. There shall be one vote per member.

16 Standing Rules of the General Assembly, continued

General Assembly – July 8, 2016 – Destin, FL

2. No ballot shall be counted if: 1. The ballot contains more than one vote for the same candidate; or 2. The ballot contains more votes than vacant positions; or 3. The ballot contains fewer votes than the number of vacancies to be filled. 3. Candidates shall be declared elected when he/she receives a majority vote of the voting members present and voting during the meeting of the General Assembly. 4. If there is only one candidate for any office, the speaker shall declare that nominee elected. 5. If there are three or more candidates for one vacancy, and no candidate receives a majority vote on the first ballot, a second ballot shall be taken between the two candidates receiving the highest number of votes on the first ballot.

16. Voting and the process for election of Board candidates shall be as follows: a) There shall be one vote per member. b) No ballot shall be counted if: 1. The ballot contains more than one vote for the same candidate; or 2. The ballot contains more votes than vacant positions; or 3. The ballot contains fewer votes than the number of vacancies to be filled.

17. The methods of electing the resident and student candidates shall be in accordance with guidelines approved by the Board of Directors. The names of these two candidates and their credentials shall be forwarded to the General Assembly. If the General Assembly does not approve the resident and/or student candidate(s), the Board shall designate some other individual(s) to fill the unfilled position(s). Such individual(s) shall be named at the first meeting of the Board of Directors following adjournment of the General Assembly.

18. The elected officers and directors shall take office at the conclusion of the annual meeting of the General Assembly at which their election occur, and whose term shall expire at the conclusion of the next annual meeting of the General Assembly or when their respective successors are elected.

17 Principal Rules Governing Motions

General Assembly – July 8, 2016 – Destin, FL

Source: The American Institute of Parliamentarians Standard Code of Parliamentary Procedure-May 2012

18 Necrology Report

General Assembly – July 8, 2016 – Destin, FL

In Memoriam

The Legislative and Membership Issues Committee is pleased to report that it did not lose any Academy members between July 1, 2015 and July 1, 2016.

19 Member Anniversaries

General Assembly – July 8, 2016 – Destin, FL

Members Celebrating Anniversaries in 2016

60 Years of Membership Carter Boyd, MD Kyle Dean, MD, FAAFP Sol Courtman, MD, FAAFP Vicki Cobb, MD J. Erwin, MD Bruce Craig, MD, FAAFP Christopher Foret, MD 55 Years of Membership Miguel Culasso, MD Ravindra Goel, MD Willie Bienvenu, MD, FAAFP Dwight Curtis, MD, FAAFP Tammy Jones, DO, FAAFP Richard Michel, MD, FAAFP Robert Davis, MD, FAAFP Benjamin Martinez, MD Harry Winters, III, MD, FAAFP Neal Duhon, MD, FAAFP Wendy Moses, MD James Eppinette, MD Kay Nelson, MD 50 Years of Membership Gregory Ferrara, MD Alberto Palmiano, MD, FAAFP Melvin Bourgeois, MD, FAAFP Dennis Fletcher, MD Robert Post, MD C. H. Nash, MD, FAAFP Jesus Garcia, MD, FAAFP David Silar, MD Albert Rees, MD, FAAFP Donald Givler, MD Deidre Stelly, MD Benson Grigsby, MD Mary Thomas, MD, FAAFP 45 Years of Membership Ty Hargroder, MD, FAAFP Michael Dolan, MD, FAAFP Stephen Horne, MD, FAAFP James Falterman, MD, FAAFP Carlos Irizarry, MD, FAAFP Michael Jennings, MD, FAAFP 40 Years of Membership Patrick Jones, MD Mary Baudier, MD, FAAFP James Kerl, MD, FAAFP Frank Guidry, MD, FAAFP James Larrison, MD Edward Jeffries, MD, FAAFP Francine Manuel, MD Dennis LaRavia, MD, FAAFP Michael McSween, MD, FAAFP Allen Richert , MD, FAAFP Louis Minsky, MD J. Louis Tonore, Jr., MD, FAAFP Philip Oravetz, MD, FAAFP Fred Willis, MD, FAAFP Donald Peterson, MD, FAAFP Bryan Picou, MD, FAAFP 35 Years of Membership Randall Poche, MD Marion Cash, MD, FAAFP Donald Reed, MD Frederick Hackley, MD, FAAFP Charles Reed, MD Stephen Harris, MD Clifton Salmon, MD Dan Lafleur, MD, FAAFP Michael Screpetis, MD Richard Marek, MD Michael Seep, MD Lovell Mayeux, MD, FAAFP Mona Shalaby, MD Christy Montegut, MD, FAAFP Clinton Sharp, MD Susan Richarme, MD, FAAFP A. John Tassin, MD Robert Ryan, MD Thomas Trahan, MD Dominick Scimeca, MD, FAAFP Ted Warren, MD, FAAFP E. Benson Scott, MD, FAAFP Sharon Werner, MD James Smith, MD, FAAFP Flynn Taylor, MD, FAAFP 25 Years of Membership Derek Anderson, MD, FAAFP 30 Years of Membership Charles Balette, MD, FAAFP Peggy Allemand, MD, FAAFP Alan Broussard, MD Gregory Allen, MD Eldridge Burns , MD Kerry Anders, MD Jesus Chua, MD 20 Current LAFP Officers

General Assembly – July 8, 2016 – Destin, FL

2015-16 Officers

Brian Elkins, MD President James A. Taylor, Jr., MD President-Elect M. Tahir Qayyum, MD Vice-President Christopher Foret, MD Secretary Bryan Picou, MD Treasurer Melvin Bourgeois , MD Immediate Past President Derek Anderson, MD Speaker, General Assembly Daniel Jens, MD Vice-Speaker, General Assembly

AAFP Delegates and Alternates

Delegates Alternates Russell Roberts, MD James Campbell, MD Marguerite Picou, MD Bryan Picou, MD

District Directors

Director Alternate Director First District Mary Coleman, MD William Woessner, MD Second District Daniel Jens, MD Luis Arencibia, MD Third District “A” Jack Heidenreich, MD Camille Pitre, MD Third District “B” Indira Gautam, MD Zeb Stearns, MD Fourth District Ricky Jones, MD Gregory Bell, MD Fifth District Tobe Momah, MD James Smith, MD Sixth District “A” Phillip Ehlers, MD Carol Smothers, MD Sixth District “B” Richard Bridges, MD Keisha Harvey, MD Seventh District Jason Fuqua, MD Andrew Davies, MD Eighth District Jonathan Hunter, MD Matthew Erickson, MD Director at Large Jody George, MD Esther Holloway, MD

Resident Becky Batiste, MD Clayton Runfalo, MD Student Koby Lanclos Cara Permenter

Staff Ragan LeBlanc - Executive Vice President Lee Ann Albert - Membership and Education Director Katie Underwood – Foundation Coordinator Joe & Sandy Mapes and Bilee Yelverton - LAFP Lobbyist

21 Guest Speaker – Robert Muscalus, DO Medical Director – Care Transformation Blue Cross Blue Shield of LA General Assembly – July 8, 2016 – Destin, FL

Dr. Rob Muscalus is the Medical Director for Care Transformation at BlueCross BlueShield of Louisiana (BCBSLA). In this capacity, he provides leadership and support for the growth and development of BCBSLA’s “pay for value” and shared savings programs. For the past 22 years, he has held senior leadership and medical management positions in the healthcare industry. He also served for six years in state government as Pennsylvania’s Physician General, being an advisor to the Governor and Secretary of Health on matters pertaining to public health. Dr. Muscalus earned a degree in Economics from the College of William and Mary where he was also named a First Team Academic All American Football Player. He is a graduate of the Philadelphia College of Osteopathic Medicine and completed his training in Family Medicine at the Geisinger Medical Center in Danville, PA.

22 Guest Speaker – Dan Claitor, JD Louisiana State Senator

General Assembly – July 8, 2016 – Destin, FL

Daniel Albert Claitor (born August 3, 1961), known as Dan Claitor, is a Baton Rouge attorney and a Republican member of the Louisiana State Senate. Claitor earned his B.A. in finance from Louisiana State University and his J.D. from Loyola University.

His professional experience includes working as a publisher, Prosecutor for Orleans Parish District Attorney's Office, Legal Counselor, and manager of a family business. In 1987, Claitor was named an assistant district attorney for the Orleans Parish District Attorney's office, where he claimed a good record in fighting crime. Claitor entered private practice in Baton Rouge in 1990.

On April 4, 2009, Claitor defeated fellow Republican Lee Domingue, a Baton Rouge businessman backed by Governor Bobby Jindal, in a special election for the District 16 Senate seat vacated by Republican U.S. Representative Bill Cassidy. Senator Claitor calls himself a "constructive conservative" and "a team player with an independent approach". He currently serves as Chairman of Senate Committee on Judiciary C and serves as a member of the Senate Committee on Health & Welfare.

He and his wife, the former Sharmaine Leblanc, have two sons, Sam and James Claitor. They are Roman Catholic.

23 Guest Speaker – Robert L. Wergin, MD, FAAFP AAFP Board Chair

General Assembly – July 8, 2016 – Destin, FL

Robert L. Wergin, MD, FAAFP, a family physician in Milford, Nebraska, is board chair of the American Academy of Family Physicians. Previously, he served one- year terms as president and president-elect, and three years as a member of the AAFP Board of Directors. The AAFP represents 124,900 physicians and medical students nationwide.

As board chair of the AAFP, Wergin advocates on behalf of family physicians and patients nationwide to inspire positive change in the U.S. health care system.

Outside the AAFP, Wergin is a practicing family physician in the town where he was born and raised. He practices the full spectrum of family medicine at the Milford Family Practice Center, from obstetrics to geriatrics. He also serves as medical director of Crest View Care Center.

Growing up in a rural setting, Wergin learned the importance of community involvement. Wergin currently serves on the board of the Milford Public Schools Foundation, is medical director for the Milford volunteer fire department, team physician for Milford Public Schools, and sideline physician for the Nebraska Shrine Bowl. He also serves as Milford city physician, and is an instructor of advanced cardiac and advanced trauma life support. In addition, Wergin is a volunteer faculty member at the University of Nebraska Medical Center, teaching medical students and residents on their rural rotations.

At the national level, Wergin has been an active member of the AAFP since 1982. He served as a delegate and alternate delegate to the AAFP’s Congress of Delegates for 12 years. He is a former member of the AAFP’s Commission on Membership and Member Services and the Website Advisory Committee.

At the state level, Wergin has been an active member of the Nebraska Academy of Family Physicians since 1989, where he has served in numerous leadership positions, including president and board member. He was instrumental in passing LB-396 in the Nebraska legislature, which established the state’s first Medicaid medical home pilot project. He currently serves as a governor-appointed member of the project’s design and implementation task force. Wergin is also an active member of the Nebraska Medical Association, where he currently serves as councilor for the 6th District.

Wergin was awarded the Nebraska Family Physician of the Year award in 2002, Nebraska Nursing Home Medical Director of the Year in 2012, and Nebraska Outstanding Rural Family Physician of the Year for Nebraska in 2015.

He graduated summa cum laude from the University of Nebraska, Kearney, with a bachelor’s degree in biology and chemistry. He earned his medical degree from the University of Nebraska Medical Center, Omaha, and he completed his family medicine residency at St. Mary’s Hospital and Medical Center in Grand Junction, Colorado, where he served as an assistant director. Wergin also served as assistant director of the Lincoln Family Practice Residency, which is affiliated with the University of Nebraska Medical Center.

Wergin is board certified by the American Board of Family Medicine and has the AAFP Degree of Fellow, an earned degree awarded to family physicians for distinguished service and continuing medical education.

24 Unfinished Business

General Assembly – July 8, 2016 – Destin, FL

There is no unfinished business to report.

25 New Business

General Assembly – July 8, 2016 – Destin, FL

26 Follow-up Actions Taken on Resolutions from the 2015 General Assembly

General Assembly – July 8, 2016 – Destin, FL

Louisiana Academy of Family Physicians 2015 General Assembly All items are complete. Action Grid – As of June 2016 Resolutions Executive Committee Action Taken Approved Action: Resolution 1: Background A draft of a letter will be Ongoing Checks and Education For discussed during the LAFP Board Patients Regarding Gun Safety of Directors meeting in July.

RESOLVED, that the Louisiana Academy of Family Physicians inform our state and federal legislators of the AAFP policy on prevention of gun violence and encourage them to promote legislation consistent with this policy.

Resolution 2: Resolution of Resolution was submitted to Completed – September, 2015 Condolence – David Euans, MD the AAFP Congress of Delegates and approved as written. RESOLVED, that the American Academy of Family Physicians join the Louisiana Academy of Family Physicians in recognizing Dr. David Euan’s invaluable contributions to Family Medicine, and be it further

RESOLVED, that a copy of this resolution be forwarded to Dr. David Euan’s family as an expression of condolence.

Resolution 3: Establish a Final guidelines and nomination Completed – March, 2016 Resident Award of Excellence form were approved and nominations were accepted for RESOLVED, that the Louisiana a 2016 recipient. Academy of Family Physicians Foundation establish a Resident Award of Excellence and recognize resident leadership, scholarly activity and family medicine research.

27 Resolution 4: Dues Increase for Dues increase was sent to the Completed – August, 2015 Active, Inactive and Supporting AAFP to reflect in the 2016 Membership invoices.

RESOLVED, that the Louisiana Academy of Family Physicians (LAFP) Board of Directors urges the membership to approve for the annual dues for active members of the LAFP will increase $25 dollars beginning January 2016 resulting in the total annual dues for chapter dues to be $300 dollars be approved by the General Assembly at its August, 2015 meeting.

Resolution 5: Late Term The LAFP policy manual has A resolution will be submitted Abortions been amended to reflect to the AAFP for debate at the approved policy at the 2015 2016 Congress of Delegates RESOLVED, that the LAFP is General Assembly meeting. meeting in Orlando, FL. against performing elective abortions 20 weeks and after, Draft of a resolution has been and further be it submitted by the author for the board to review for submission RESOLVED, that the LAFP at the 2016 AAFP Congress of submit a resolution to the AAFP Delegates. Congress of Delegates to set such policy to also not support or endorse elective late term abortions in the United States.

Resolution 6: Recognizing the The LAFP policy manual has Completed – September, 2015 Importance of Vaccinations and been amended to reflect Immunizations in Louisiana approved policy at the 2015 General Assembly meeting. RESOLVED, the Louisiana Academy of Family Physicians (LAFP) endorses the concept that all children and adults, regardless of economic and insurance status, should have access to all immunizations recommended by the AAFP; and further be it

RESOLVED, LAFP strongly recommends that patients receive all immunizations recommended by the AAFP in their medical home and when recommended vaccines are

28 provided outside of the medical home, all pertinent vaccine related information should be provided to the patient’s medical home.

Resolution 7: Medical and The LAFP policy manual has Completed – September, 2015 Recreational Use of Marijuana been amended to reflect approved policy at the 2015 RESOLVED, That the Louisiana General Assembly meeting. Academy of Family Physicians strongly oppose the recreational use of all medications and drugs of abuse, and be it further

Resolution 8: Nurse The LAFP policy manual has Completed – September, 2015 Practitioners been amended to reflect approved policy at the 2015 RESOLVED, that advanced nurse General Assembly meeting. practitioners should not be granted full license authority; and be it further

RESOLVED, that in the interest to maintain the highest quality of care and to maintain the highest quality of medical standards to Louisiana patients, the LAFP adopt the policy that states “a nurse practitioner should only function in an integrated practice arrangement under the direction and responsible supervision of a practicing, licensed physician. In no instance may duties be delegated to a nurse practitioner for which the supervising physician does not have the appropriate training, experience and demonstrated competence.”

2015 General Assembly Minutes Approval

General Assembly – July 8, 2016 – Destin, FL

GENERAL ASSEMBLY MINUTES Hotel Monteleone, New Orleans, LA August 7, 2015- 1:00 pm

PRESENT: Derek Anderson, MD, FAAFP Michael Harper, MD, FAAFP Christian Mayorga, MD Khaled Aqeel, MD Brian Harrell, MD Camille Pitre, MD Luke Baudoin, MD Chris Hayes, MD Danielle Rushing, MD Walter Birdsall, MD FAAFP Jack Heidenreich, MD Kerry Sterling, MD Melvin Bourgeois, MD Jonathan Hunter, MD, FAAFP Devan Szczepanski, MD Kenneth Brown, MD, FAAFP Daniel Jens, MD, FAAFP James Taylor, MD James Campbell, MD Edmond Kalifey, MD FAAFP Margo Thomas, MD Lacey Cavanaugh, MD Albert Kerr, MD Hugh Washburn, MD, FAAFP Mark Dawson, MD, FAAFP Alan LeBato, MD, FAAFP Michael Williams, MD, FAAFP Brian Elkins, MD, FAAFP Randall Lillich, MD Jason Fuqua, MD William Long, MD Jody George, MD, Euil Luther, MD Wayne Gravois, MD Jose Mata, MD, FAAFP

Special Guests Paul Murphree, DO Robert L. Wergin, MD, FAAFP

LAFP Staff: Ragan LeBlanc, Executive Vice President Lee Ann Albert, Membership and Education Director Joe Mapes-LAFP Lobbyist Sandy Mapes-LAFP Lobbyist Bilee Yelverton- LAFP Lobbyist

______

CALL TO ORDER Dr. Daniel Jens called the meeting to order at 1:00 p.m.

INVOCATION Dr. Jens gave the invocation.

PLEDGE OF ALLEGIANCE Dr. Jens led the pledge of allegiance.

IN MEMORIAM REPORT Dr. Jens reviewed the Memoriam Report, he asked for a moment of silence for a member who passed away since the last General Assembly: David William Euans, MD, John Blaine Hill MD, William A. Marmande, MD, Fred A. Marks, MD.

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INTRODUCTION OF BOARD OF DIRECTORS Dr. Jens then recognized the LAFP Board members by asking them to stand. He stated that the Academy could not exist without their support. He did the same for those who have served on an LAFP Committee.

INTRODUCTION OF GUEST SPEAKER – PAUL MURPHREE, MD Dr. Anderson gave an overview of Dr. Murphree’s background stating he is currently is interim Chief Medical Officer and Medical Director of Quality and Informatics at Blue Cross and Blue Shield of Louisiana (BCBSLA). He oversees population’s health managements, utilization review, case and disease management, medical policy, wellness provider performance plan accreditation and innovative care models. Dr. Anderson proudly introduced Dr. Paul Murphree.

ADDRESS OF GUEST SPEAKER – PAUL MURPHREE, MD Dr. Murphree’s topic focused on the Affordable Care Act (ACA) or better known as “Obama Care.” He provided information and updates from Blue Cross on the ACA relative to the population being served, co-ops, and the role of the commercial insurer with regards to hospitals, physicians, and health plans. He then took questions from the audience.

INTRODUCTION OF THE GUEST SPEAKER – ROBERT L. WERGIN, MD, FAAFP Dr. Anderson then introduced Robert L. Wergin, MD, FAAFP, President of the American Academy of Family Physicians.

ADDRESS OF THE GUEST SPEAKER – ROBERT L. WERGIN, MD, FAAFP Dr. Wergin thanked the members for the opportunity to be at the General Assembly. He gave an overview regarding the work of the AAFP that included its advocacy efforts, physician workforce and resources that were available to the membership. He urged the Assembly to discuss scope of practice and other issues affecting primary care with legislators. In closing, he said, “There is never a better time to be a family physician than right now.” He then took questions from the audience.

UNFINISHED BUSINESS There was no unfinished business for discussion on the agenda.

NEW BUSINESS Follow-up taken from 2014 General Assembly Dr. Anderson stated at the follow up actions from the 2014 General Assembly was the bylaws revision that was approved during the 2014 meeting. He stated that the bylaws revision had been completed and that the Board of Directors had approved the draft.

APPROVAL OF 2014 GA MINUTES Dr. Anderson requested that all members in attendance review the minutes from 2014. The following motion was adopted by unanimous consent of the Assembly:

MOTION (APPROVED) THAT THE JULY 4, 2014 MEETING MINUTES BE APPROVED AS WRITTEN. THE MOTION CARRIED.

BOARD OF DIRECTORS REPORT A – POLICY STATEMENTS Dr. Anderson stated as a point of information, Report A from the Board of Directors regarding the LAFP Policy Statements were in the handbook. He also informed those in attendance that the Board of Directors reviewed the policies that were set to sunset and approved and made revisions as noted. Dr. Anderson encouraged those in attendance to review the LAFP policies and that they could be found in the handbook or on the LAFP website.

31 2015 General Assembly Minutes Approval, continued

General Assembly – July 8, 2016 – Destin, FL

BOARD OF DIRECTORS REPORT B – STRATEGIC PLAN Dr. Anderson then went on to discuss Report B from the Board of Directors regarding the LAFP Strategic Plan. He informed the Assembly that the board had approved a three year plan that would focus on the following objectives:

I. Advocacy Preserve and strengthen the leadership of family medicine

II. Practice Support Provide support to members in fulfilling their practice and career goals

III. Education Provide high quality education for family physicians in all practice styles

IV. Membership & Communications Ensure relationship with members is relevant, valued and communicated

V. Operations Maintain a strong, sustainable Academy accountable for supporting the membership

He informed those in attendance that the plan would be reviewed for progress annually and used by the president-elect to set the work plan for the upcoming year. Dr. Anderson encouraged those in attendance to review the LAFP policies and that they could be found in the handbook or on the LAFP website.

INTRODUCTION OF RESOLUTIONS AND LATE RESOLUTIONS Dr. Anderson announced that there were no late resolutions and closed the submission period for any late resolutions. Without further comment he proceeded with the resolutions that had been submitted for the Assembly’s consideration:

Resolution No. 1 – Background Checks and Education for Patients Regarding Gun Safety was moved by Dr. Jens then presented a brief overview of the intent. Resolution No. 1 was reported by substitute and became Substitute Resolution No. 1. Dr. Anderson after receiving approval from the Assembly opened the floor for consideration.

Substitute Resolution No. 1 Dr. Jens made the following motion by the Assembly:

Discussion was conducted on the first resolved and was amended as follows:

The following motion was made and approved by the Assembly:

MOTION (ADOPTED)

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General Assembly – July 8, 2016 – Destin, FL

THAT THE LOUISIANA ACADEMY OF FAMILY PHYSICIANS INFORM STATE AND CONGRESSIONAL LEGISLATORSOF THE AAFP POLICY ON PREVENTION OF GUN VIOLENCE AND ENCOURAGE THE PROMOTION OF STATE OR FEDERAL LEGISLATION BE ADOPTED AS WRITTEN. THE MOTION CARRIED

Discussion was conducted on the second resolved and was amended as follows:

RESOLVED, that the Louisiana Academy of Family Physicians encourage its members to discuss firearm safety with their patients, including issues that may include trigger locks, and education about handling guns and how to control anger.

The following motion was made by the Assembly:

MOTION (FAILED TO BE ADOPTED) THAT THE 2ND RESOLVE TO ENCOURAGE THE LAFP MEMBERS TO DISCUSS FIREARM SAFETY WITH THEIR PATIENTS, INCLUDING TRIGGER LOCKS AND EDUCATION ON HANDLING OF GUNS BE ADOPTED AS AMENDED. Resolution No.2 – Condolence Resolution. Dr. Anderson stated this is a condolence resolution for Dr. David Euan. Dr. Anderson after receiving approval from the Assembly, opened the floor for consideration. Dr. Anderson read the two Resolves.

RESOLVED, that the American Academy of Family Physicians join the Louisiana Academy of Family Physicians in recognizing Dr. David Euan’s invaluable contributions to Family Medicine, and be it further

RESOLVED, that a copy of this resolution be forwarded to Dr. David Euan’s family as an expression of condolence.

The following motion was made by the Assembly:

MOTION (ADOPTED) THAT THE AMERICAN ACADEMY OF FAMILY PHYSICIANS JOIN THE LOUISIANA ACADEMY OF FAMILY PHYSICIANS IN RECOGNIZING DR. DAVID EUAN’S INVALUABLE CONTRIBUTIONS TO FAMILY MEDICINE AND THAT A COPY OF THIS RESOLUTION BE FORWARDED TO DR. DAVID EUAN’S FAMILY AS AN EXPRESSION OF CONDOLENCE BE ADOPTED AS WRITTEN.

Resolution No. 3 – Establish a Resident Award of Excellence. Mr. Frank DePaula, Alternate Student Delegate to the General Assembly moved the Resolution and offered an amendment. Dr. Anderson after receiving approval from the Assembly opened the floor for consideration.

RESOLVED, that the Louisiana Academy of Family Physicians Foundation establish a Resident Award of Excellence and recognize resident leadership, scholarly activity and family medicine research.

The following motion was made by the Assembly:

33 2015 General Assembly Minutes Approval, continued

General Assembly – July 8, 2016 – Destin, FL

MOTION (ADOPTED) THAT THE LAFP FOUNDATION ESTABLISH A RESIDENT AWARD OF EXCELLENE AND RECOGNIZE RESIDENT LEADERSHIP, SCHOLARY ACTIVITY AND FAMILY MEDICINE RESEARCH BE ADOPTED AS AMENDED.

Resolution No. 4 – Dues Increase for Active, Inactive and Supporting Membership. Dr. Anderson indicated there was no need for this resolution because the Bylaws state in part that the Assembly votes on the dues increases with the recommendation from the Board of Directors. However, he will handle it this year as a resolution and stated the General Assembly can vote to approve or not approve the Board of Directors recommendation of a dues increase. Dr. Anderson opened the floor for consideration. RESOLVED, that the Louisiana Academy of Family Physicians (LAFP) Board of Directors urges the membership to approve for the annual dues for active members of the LAFP will increase $25 dollars beginning January 2016 resulting in the total annual dues for chapter dues to be $300 dollars be approved by the General Assembly at its August, 2015 meeting.

The following motion was made: MOTION (ADOPTED) THAT THE LOUISIANA ACADEMY OF FAMILY PHYSICIANS (LAFP) BOARD OF DIRECTORS URGES THE MEMBERSHIP TO APPROVE FOR THE ANNUAL DUES FOR ACTIVE MEMBERS OF THE LAFP WILL INCREASE $25 DOLLARS BEGINNING JANUARY 2016 RESULTING IN THE TOTAL ANNUAL DUES FOR CHAPTER DUES TO BE $300 DOLLARS, BE ADOPTED AS WRITTEN.

The motion carried.

Resolution No. 5 - Late Term Abortions. Dr. Gravois read the resolves and discussed his intent of the resolution. He then moved that the resolution be adopted. Dr. Anderson after receiving approval from the Assembly opened the floor for consideration.

RESOLVED, that the LAFP is against performing abortions 20 weeks and after, and further be it

RESOLVED, that the LAFP submit a resolution to the AAFP Congress of Delegates to set such policy to also not support or endorse late term abortions in the United States.

The Assembly discussed the resolution and after lengthy debate, Dr. Cavanaugh made the following motion:

MOTION (ADOPTED) THAT THE TWO RESOLVES IN RESOLUTION NO. 5 BE CONSIDERED SEPARATELY.

Discussion was conducted on the first resolved and was amended as follows:

RESOLVED, that the LAFP is against performing elective abortions 20 weeks and after, and further be it

The following motion was made:

34 2015 General Assembly Minutes Approval, continued

General Assembly – July 8, 2016 – Destin, FL

MOTION (FAILED TO BE ADOPTED) THAT THE LAFP IS AGAINST PERFORMING ELECTIVE ABORTIONS, BE ADOPTED AS AMENDED.

The first resolved reverted back to its original format. Discussion was conducted on the first resolved:

RESOLVED, that the LAFP is against performing elective abortions 20 weeks and after, and further be it

MOTION (ADOPTED) THAT THE LAFP IS AGAINST PERFORMING ELECTIVE ABORTIONS, BE ADOPTED AS AMENDED.

Discussion was conducted on the second resolved and was amended as follows:

RESOLVED, that the LAFP submit a resolution to the AAFP Congress of Delegates to set such policy to also not support or endorse elective late term abortions in the United States.

MOTION (ADOPTED) THAT THE LAFP SUBMIT A RESOLUTION TO THE AAFP CONGRESS OF DELEGATES TO SET SUCH POLICY TO ALSO NOT SUPPORT OR ENDORSE ELECTIVE LATE TERM ABORTIONS IN THE UNITED STATES, BE ADOPTED AS AMENDED.

Resolution No. 6 - Recognizing the Importance of Vaccinations and Immunizations in Louisiana. This resolution was submitted by the LAFP Board of Directors. Resolution No. 6 was reported by substitute and became Substitute Resolution No. 6. Dr. Anderson read the two resolves.

RESOLVED, the Louisiana Academy of Family Physicians (LAFP) endorses the concept that all children and adults, regardless of economic and insurance status, should have access to all immunizations recommended by the AAFP; and further be it

RESOLVED, LAFP strongly recommends that patients receive all immunizations recommended by the AAFP in their medical home and when recommended vaccines are provided outside of the medical home, all pertinent vaccine related information should be provided to the patient’s medical home.

Dr. Anderson after receiving approval from the Assembly opened the floor for consideration. Discussion was conducted and the following motion was made:

MOTION (ADOPTED) THAT THE LOUISIANA ACADEMY OF FAMILY PHYSICIANS (LAFP) ENDORSE THE CONCET THAT ALL CHILDREN AND ADULTS, REGARDLESS OF ECONOMIC AND INSURANCE STATUS, SHOULD HAVE ACCESS TO ALL IMMUNIZATGIONS RECOMMENDED BY THE AAFP AND THE LAFP STRONGLY RECOMMENDS THAT PATIENTS RECEIVE ALL IMMUNIZATIONS RECOMMENDED BY THE AAFP IN THEIR MEDICAL HOME AND WHEN RECOMMENDED VACCINES RELATED INFORMATION SHOULD BE PROVIDED TO THE PATIENT’S MEDICAL HOME, BE ADOPOTED AS WRITTEN.

35 2015 General Assembly Minutes Approval, continued

General Assembly – July 8, 2016 – Destin, FL

The motion carried.

Resolution No. 7 - Medical and Recreational Use of Marijuana. Dr. Anderson read the two resolves. Dr. Anderson after receiving approval from the GA, opened the floor for consideration.

Dr. Gravois made the following motion:

MOTION (ADOPTED) THAT THE TWO RESOLVES, IN RESOLUTION NO. 7 BE CONSIDERED SEPARATELY.

The motion carried.

Discussion was conducted on the first resolved.

RESOLVED, That the Louisiana Academy of Family Physicians strongly oppose the recreational use of all medications and drugs of abuse, and be it further

The following motion was made: MOTION (ADOPTED) THAT THE LOUISIANA ACADEMY OF FAMILY PHYSICIANS STRONGLY OPPOSE THE RECREATIONAL USE OF ALL MEDICATIONS AND DRUGS OF ABUSE, BE ADOPED AS WRITTEN.

The motion carried.

Discussion was conducted on the second resolved.

RESOLVED, That the Louisiana Academy of Family Physicians support the medical use of marijuana for those patients who do not respond to standard existing therapeutic measures.

The following motion was made:

MOTION (FAILED TO BE ADOPTED) THAT THE LOUISIANA ACADEMY OF FAMILY PHYSICIANS SUPPORT THE MEDICAL USE OF MARIJUANA FOR THOSE PATIENTS WHO DO NOT RESPOND TO STANDARD EXISTING THERAPEUTIC MEASURES, BE ADOPTED AS WRITTEN.

The motion was failed to be adopted.

Resolution No. 8- Nurse Practitioners. This resolution was submitted by the LAFP Board of Directors. Dr. Taylor discussed the resolution with the Assembly and offered amendments to the first resolved. Dr. Taylor moved to approve the resolution as amended. Dr. Anderson after receiving approval from the GA opened the floor for consideration.

Discussion was conducted on the resolution as amended as follows:

RESOLVED, that advanced nurse practitioners should continue their collaborative agreements with physicians and not be granted full license authority for the reasons given above; and be it further

36 2015 General Assembly Minutes Approval, continued

General Assembly – July 8, 2016 – Destin, FL

The following motion was made:

MOTION (ADOPTED) THAT ADVANCED NURSE PRACTITIONERS SHOULD NOT BE GRANTED FULL LICENSE AND THAT IN THE INTEREST TO MAINTAIN THE HIGHEST QUALITY OF CARE AND TO MAINTAIN THE HIGHEST QUALITY OF MEDICAL STANDARDS TO LOUISIANA PATIENTS, THE LAFP ADOPT THE POLICY THAT STATES “A NURSE PRACTITIONER SHOULD ONLY FUNCTION IN AN INTEGRATED PRACTICE ARRANGEMENT UNDER THE DIRECTION AND RESPONSIBLE SUPERVISION OF A PRACTICING, LICENSED PHYSICIAN. IN NO INSTANCE MAY DUTIES BE DELEGATED TO A NURSE PRACTITIONER FOR WHICH THE SUPERVISING PHYSICIAN DOES NOT HAVE THE APPROPRIATE TRAINING, EXPERIENCE AND DEMONSTRATED COMPETENCE”, BE ADOPTED AS WRITTEN.

The motion carried.

INTRODUCTION OF PAST PRESIDENTS Dr. Anderson asked all past presidents of the LAFP to stand for recognition.

INTRODUCTION OF COMMITTEE MEMBERS Dr. Anderson asked for members who served on a committee to stand for recognition.

REPORT OF EXECUTIVE VICE PRESIDENT – RAGAN LEBLANC Mrs. Leblanc stated that her report was included in the handbook and didn’t have anything additional to add.

REPORT OF OFFICERS There were no verbal officer reports given during the General Assembly meeting. All reports were included in the handbook.

REPORTS OF COMMITTEE Dr. Anderson, in Dr. Bryan Picou’s absence, stated that the2014 year-end financial statement showed the LAFP is sound. A copy of the audit report is included in the handbook.

NOMINATING COMMITTEE- James A. Taylor, Jr. MD Dr. Taylor reported the nominations for the LAFP Foundation and the LAFP Academy Board of Directors. He referred to the nomination slates included in the handbook. Dr. Anderson called for any member from the floor interested in making a nomination for any position to make it known at this time. Hearing none, the nominations were closed.

LEGISLATIVE & MEMBERSHIP ISSUES COMMITTEE – James A. Taylor, Jr., MD Dr. Anderson asked if Dr. Taylor had anything to add to the Legislative and Membership Issues Committee report included in the packet. Dr. Taylor stated that he did not have anything additional to add.

MATCH DATA

37 2015 General Assembly Minutes Approval, continued

General Assembly – July 8, 2016 – Destin, FL

Dr. Anderson reported the Match Data for Family Medicine Residency Programs for 2014-2015 and announced that the reports were located in the handbook. He stated all 69 slots were filled for Family Medicine Residency Programs.

DISTRICT DIRECTOR/ALTERNATE REPORTS No verbal or written reports were provided.

FAMILY MEDICINE DEPARTMENT REPORTS Dr. Anderson stated that written reports were submitted and included in the handbook.

FAMILY MEDICINE RESIDENCY PROGRAM DIRECTOR REPORTS Dr. Anderson stated that the written Residency Program reports submitted were included in the handbook. He announced at the end of August, he is stepping down as Residency Program Director at the Baton Rouge General and Dr. Brian Harrell had been hired to fill the position.

LAFP FOUNDATION Dr. Anderson stated that a written report was submitted and is included in the handbook.

2015 FAMILY MEDICINE AWARD WINNERS Dr. Anderson stated the Family Medicine winners for 2015 is included in the handbook and listed on the LAFP website. He congratulated the winners.

LAFAMPAC BOARD – Marguerite “Cissy” Picou, MD Dr. Anderson, in the absence of Dr. Marguerite “Cissy” Picou, stated the PAC did very well in its drive to increase PAC contributions last year. He stated, in order for he and the Picou’s to continue to make the match, fifty new donations are needed by Sunday, August 9. He expressed the importance of donating to LaFamPac.

ELECTION RESULTS Due to there being no special elections during the General Assembly, the following officers were elected for the 2015- 2016 year.

President: Brian Elkins, MD, Alexandria, LA President-Elect: James Taylor, MD, Zachary, LA Vice President: M. Tahir Qayyum, MD, Bastrop, LA Secretary: Christopher Foret, MD, Franklinton, LA Treasurer: Bryan Picou, MD, Natchitoches, LA Immediate Past President: Melvin G. Bourgeois, MD, Morgan City, LA Speaker: Derek Anderson, MD, Baton Rouge, LA Vice-Speaker/GA: Daniel Jens, MD, Mandeville, LA AAFP Delegate: Russell Roberts, MD, Shreveport, LA AAFP Delegate: Marguerite Picou, MD, Natchitoches, LA AAFP Alternate Delegate: James Campbell, MD, Kenner, LA AAFP Alternate Delegate: Bryan Picou, MD, Natchitoches, LA

38 2015 General Assembly Minutes Approval, continued

General Assembly – July 8, 2016 – Destin, FL

Board of Directors District 1 Director: Mary Coleman, MD, New Orleans, LA District 1 Alternate: William Woessner, MD, New Orleans, LA District 2 Director: Daniel Jens, MD, Mandeville, LA District 2 Alternate: Luis Arencibia, MD, Mandeville, LA District 3A Director: Jack Heidenreich, MD, Raceland, LA District 3A Alternate: Camille Pitre, MD, Larose, LA District 3B Director: Indira Gautam, MD, Lafayette, LA District 3B Alternate: Zeb Stearns, MD, Eunice, LA District 4 Director: Ricky Jones, MD, Shreveport, LA District 4 Alternate: Gregory Bell, MD, Coushatta, LA District 5 Director: Tobe Momah, MD, West Monroe, LA District 5 Alternate: James Smith, Bastrop, LA District 6A Director: Phillip Ehlers, MD, Baton Rouge, LA District 6A Alternate: Carol Smothers-Swift, MD, New Roads, LA District 6B Director: Richard Bridges, MD, Amite, LA District 6B Alternate: Keisha Harvey, MD, Bogalusa, LA District 7 Director: Jason Fuqua, MD, Sulphur, LA District 7 Alternate: Andrew Davies, MD, Lake Charles, LA District 8 Director: Jonathan Hunter, MD, Alexandria, LA District 8 Alternate: Matthew Erickson, MD, Jena, LA District Director at Large: Jody George, MD, Lake Charles, LA District Director at Large Alt Esther Holloway, MD, Coushatta, LA

Resident Representative Becky Batiste, MD, Lacombe, LA Resident Alternate Clay Runfalo, MD, Prairieville, LA Student Representative Koby Lanclos, LSUHSC, Shreveport, LA Student Alternate Cara Permenter, LSUHSC, Shreveport, LA

Foundation Board of Directors President Michael Melvin Bourgeois, MD President-Elect Brian Elkins, MD Secretary Wayne Gravois, MD Treasurer Bryan Picou, MD Immediate Past President Melvin G. Bourgeois, MD Lay Member #1 Justin Angelle Lay Member #2 Kenny Laborde Lay Member #3 Kim Gassie Lay Member #4 Nadine Robin Lay Member #5 Barry Dunn LAFP Member #1 E. Edward Martin, MD LAFP Member #2 Russell Roberts, MD LAFP Member #3 Albert Rees, MD LAFP Member #4 Jonathan Hunter, MD

39 2015 General Assembly Minutes Approval, continued

General Assembly – July 8, 2016 – Destin, FL

ADDITIONAL NEW BUSINESS There was no additional new business.

ANNOUNCEMENTS Dr. Anderson informed the Assembly that Blue Cross and Blue Shield of Louisiana was hosting the annual LAFP Foundation Auction and President’s Party at The National World War II Museum at 7:00 pm.

ADJOURNMENT This concluding the General Assembly business, the following motion was made by unanimous consent of the Assembly:

MOTION (APPROVED) THAT THE GENERAL ASSEMBLY MEETING BE ADJOURNED AT 3:06 PM. THE MOTION CARRIED.

Respectfully submitted,

Derek Anderson, MD Speaker General Assembly

Dan Jens, MD Vice-Speaker General Assembly

40 Resolution 1 Dues Increase for Active, Inactive and Supporting Membership

General Assembly – July 8, 2016 – Destin, FL

Louisiana Academy of Family Physicians 2016 General Assembly

RESOLUTION NO 1.

Dues Increase for Active, Inactive and Supporting Membership

Submitted by: LAFP Board of Directors

1 WHEREAS, the Louisiana Academy of Family Physicians (LAFP) Board of Directors discussed the issue of a 2 dues increase of $10 dollars starting in 2017 and made the determination that this dues increase of $10 3 dollars is essential to maintain LAFP’s ability to maintain financial viability, and 4 5 WHEREAS, Louisiana Academy of Family Physicians (LAFP) Board of Directors, in recognition of this need, 6 approved the dues increase of $10 dollars starting in 2017, therefore, be it 7 8 RESOLVED, that the Louisiana Academy of Family Physicians (LAFP) Board of Directors urges the 9 membership to approve for the annual dues for active members of the LAFP will increase $10 dollars 10 beginning January 2017 resulting in the total annual dues for chapter dues to be $310 dollars be approved 11 by the General Assembly at its July, 2016 meeting. 12 13 14 Background Information 15 The current LAFP Bylaws state that the Board of Directors fiduciary responsibility for setting active member 16 dues each year, up to a certain amount. Once that capped amount is reached, the General Assembly must 17 increase this cap by a 2/3 vote. The Bylaws also give the Board of Directors fiduciary responsibility for setting 18 annual dues for other member classifications. Minimal dues increases have occurred one time in five years 19 with the annual dues for active members being $300 per year. 20 21 The LAFP had its last dues increase in the amount of $25 approved by the General Assembly in 2015. 22 23 As of 1/1/16 the Louisiana Academy Family Physicians is considered a medium chapter (401-1,000 active 24 members) along with 14 other chapters the same size and their chapter dues are as follows: 25 26 1. Alabama $295 27 2. Arkansas $250 28 3. Connecticut $300 29 4. Idaho $250 30 5. Kentucky $350 31 6. Louisiana $300 32 7. Maine $180 33 8. Maryland $350

41 Resolution 1:Dues Increase for Active, Inactive and Supporting Membership, continued

General Assembly – July 8, 2016 – Destin, FL

34 9. Mississippi $250 35 10. Nebraska $325 36 11. New Hampshire $145 37 12. New Mexico $270 38 13. Oklahoma $275 39 14. Utah $250 40 15. West Virginia $275 41 42 There are 3 chapters that their dues are higher than the Louisiana Chapter, 10 chapters are lower and 1 43 chapters that are the same. 44 45 AAFP History 46 In 1994, the bylaws were amended to increase the active member dues cap to $350. The cap was not 47 increased for 14 years, until 2008, when it was increased to $450. Thus, the rarity of seeking an increase in 48 the cap is demonstrative of the board’s caution in increasing dues, together with the long-standing trust by 49 the CoD in the board’s management of active member dues decisions. 50 51 The AAFP initiated a dues increase of dues of $10 (from $405 to $415), effective January 1, 2014, dues of $5 52 (from $415 to $420), effective January 1, 2015, dues of $10 (from $420 to $430), effective January 1, 2016 53 and dues of $10 (from $430 to $440), effective January 1, 2017.

42 Resolution 2 Division of Legislative & Membership Issues Committee

General Assembly – July 8, 2016 – Destin, FL

1 Louisiana Academy of Family Physicians 2 2016 General Assembly 3 4 RESOLUTION NO 2. 5 6 Division of the Legislative and Membership Issues Committee 7 8 Submitted by: LAFP Board of Directors 9 10 11 WHEREAS, the Louisiana Academy of Family Physicians General Assembly combined the Public 12 Issues and the Physician Advocacy Committees and formed the Committee on Legislative & 13 Membership Issues in 2001, and 14 15 WHEREAS, Louisiana Academy of Family Physicians (LAFP) Board of Directors, discussed the 16 important work of the Legislative and Membership Issues Committee and the concern that the legislative 17 issues were being focused on, not allowing for focus on membership recruitment and retention, and 18 19 WHEREAS, Louisiana Academy of Family Physicians (LAFP) Board of Directors, approved at the 20 October, 2015 to support the Legislative and Membership Issues Committee being separated into two 21 separate committees, forming the Legislative and Advocacy Committee and Membership Committee, 22 therefore, be it 23 24 RESOLVED, that the Louisiana Academy of Family Physicians (LAFP) Board of Directors urges the 25 membership to separate the Legislative and Membership Issues Committee being into two separate 26 committees, forming the Legislative and Advocacy Committee and Membership Committee be approved 27 by the General Assembly at its July, 2016 meeting.

43 Past Presidents

General Assembly – July 8, 2016 – Destin, FL

Year Name City, State 1947 Jason P. Sanders, MD* Shreveport 1948 Guy R. Jones, MD* New Orleans 1949-1950 Dorman B. Barber, MD* Alexandria 1951 Joel B. Gray, MD * New Orleans 1952 Marquis C. Wiginton, MD* Hammond 1953 Eldredge L. Carroll, MD* Columbia 1954 John W. Atkinson, MD* Gretna 1955 Janie M. Topp, MD* Lake Charles 1956 Vincent P. Blandino, MD* New Orleans 1957 Jason C. Sanders, MD* Shreveport 1958 Julius W. Daigle, MD* Paincourtville 1959 Esmond A. Fatter, MD New Orleans 1960 J. William Crookshank, MD* Lake Charles 1961 Ernest B. Flake, MD* Shreveport 1962 Boyd M. Woodard, MD* Lake Charles 1963 Francis M. Brian, MD Alexandria 1964 Edward M. Harrell, MD* Lafayette 1965 Francis I. Nicolle, MD* New Orleans 1966 Roy G. Folse, MD Donaldsonville 1967 William C. Reeves, MD Bernice 1968 Santo E. Taormina, MD* New Orleans 1969 Eli Sorkow, MD* Lake Charles 1970 Durrell A. Hiller, MD* Shreveport 1971 Yves Guillory, MD* New Orleans 1972 William H. Brown, MD Alexandria 1973 Richard M. Pullig, MD* Clinton 1974 Robert Looney, MD Lake Charles 1975 Gerald R. Gehringer, MD* New Orleans 1976 Vance G. Byars, MD* Baton Rouge 1977 Frank G. Rieger, MD* Gonzales 1978 Rafael C. Sanchez, MD* Hammond 1979 W. Lucien Simpson, MD* Lockport 1980 Gerald C. Keller, MD Mandeville 1981 William Mitchell, MD Baton Rouge 1982 Donald E. Hines, MD Bunkie 1983 Edward E. Jeffries, MD Baton Rouge 1984 Joseph Thomas, MD* Natchitoches 1985 Merlin H. Allen, MD* Ponchatoula 1986 Linda C. Stewart, MD Baton Rouge 1987 Michael O. Fleming, MD Shreveport 1988 Dennis LaRavia, MD Vidalia 1989 Michael L. Madden, MD Alexandria 1990 John G. Bernard, MD Lafayette 1991-1992 Robert P. St. Amant, MD Baton Rouge 1992-1993 Robin J. O. Catlin, MD* New Orleans 1994-1995 Walter Birdsall, Jr., MD Raceland 44 Past Presidents, continued

General Assembly – July 8, 2016 – Destin, FL

1995-1996 E. Edward Martin, Jr., MD Covington 1996-1997 Robert E. Lahasky, MD New Iberia 1997-1998 Donnie Batie, MD Baton Rouge 1998-1999 Wayne D. Gravois, MD Zachary 2000-2001 Harold L. “Skip” Ishler, Jr., MD Denham Springs 2001-2002 Michael J. Marcello, MD Mathews 2002-2003 Marguerite B. Picou, MD Natchitoches 2003-2004 Richard H. Streiffer, MD New Orleans 2004-2005 Derek Anderson, MD Baton Rouge 2005-2006 Kim Edward LeBlanc, MD New Orleans 2006-2007 Bryan Picou, MD Natchitoches 2007-2008 Russell Roberts, MD Shreveport 2008-2009 James Campbell, MD Kenner 2009-2010 James Campbell, MD Kenner Mark Dawson, MD Rayne 2010-2011 Alan LeBato, MD Lake Charles 2011-2012 David Euans, MD* Metairie 2012-2013 Mark Dawson, MD Rayne 2013-2014 Michael Harper, MD Shreveport 2014-2015 Melvin Bourgeois, MD Morgan City

* DECEASED

45 Committee Members

General Assembly – July 8, 2016 – Destin, FL

Education Committee Tobe Momah, MD, Committee Chair

Derek Anderson, MD Donnie Batie, MD Gregory Bell, MD Kenneth Brown, MD James Campbell, MD Brian Elkins, MD (Ex-officio) Fred Gaupp, MD Jody George, MD Pamela Guoth, MD Michael Harper, MD Richard Hines, MD Jan Hood, MD Harold Ishler, MD Daniel Jens, MD Latonya Kelly, MD Alan LeBato, MD Euil Luther, MD Ronald Menard, MD Robert Moore, MD Ellen Mullen, MD Kiernan Smith, MD Michael Williams, MD

______

Legislative & Membership Issues Committee James A. Taylor, Jr., MD, Committee Chair

Chris Achee, MD Eldridge G. Burns, MD James Campbell, MD Lacey Cavanaugh, MD Mark Dawson, MD Phillip Ehlers, MD Brian Elkins, MD (Ex-officio) Chris Foret, MD Indira Gautam, MD Wayne Gravois, MD Alan LeBato, MD Edward Martin, Jr., MD Meredith Maxwell, MD Patrick Moore, MD Joseph Nida, MD Bryan Picou, MD Marguerite “Cissy” Picou, MD M. Tahir Qayyum, MD Nicholas Seelinger, MD Carol Smothers, MD Zeb Stearns, MD

______

Nominations Committee James A. Taylor, Jr., MD, Committee Chair

Melvin Bourgeois, MD Brian Elkins, MD Michael Harper, MD Jack Heidenreich, MD Kevin Plaisance, MD

46 Committee Members, continued

General Assembly – July 8, 2016 – Destin, FL

Operations Committee Bryan Picou, MD, Committee Chair

Derek Anderson, MD Melvin Bourgeois, MD Brian Elkins, MD (Ex-officio) Chris Foret, MD Dan Jens, MD James Taylor, Jr., MD

______

Resident and Student Leadership Committee

Resident Members Program/School Becky Batiste Bogalusa Deana Blanchard EJGH Brandon Gill Alexandria Lahri Kancharla Monroe Lauren Kendall EJGH Smita Prasad BRGMC Ryan Rhodes Lake Charles Clayton Runfalo BRGMC Stephanie Seasly Kenner Jason Shrock BRGMC Ronnie Slipman EJGH Micheal Sonier Lake Charles Francis Tran Alexandria William Wise Shreveport

Student Members Program/School Michael Bacon New Orleans Daniel Bonnette Shreveport Frank DePaula Tulane Richie Diaz Shreveport Nikki Gentile Tulane Ethan Hundley Shreveport Koby Lanclos Shreveport Cara Permeter Shreveport Payton Olson Shreveport Khine Sine Tulane Taylor Shepherd Shreveport Emily Songer Shreveport Christopher Trosclair Shreveport

47 Report of Executive Vice President

General Assembly – July 8, 2016 – Destin, FL

Executive Vice President’s Report – Ragan LeBlanc

I would like to begin by thanking you, our dedicated, resourceful and never without good cheer family physicians who always concentrate your leadership decisions based on making health primary! It is an honor and privilege to work for you. It is my pleasure to work alongside some of the brightest colleagues that keep up your chapter’s momentum and moving forward.

The past year has been another stellar year for the Louisiana Academy of Family Physicians.

Your LAFP office is located in Baton Rouge and our office hours are Monday through Friday from 8:30 am – 5:00 pm. Please know that we are always on the “other side” of the phone and we hope you will utilize us as a member benefit.

Staff There are currently four of us who work in your headquarters offices. I would like to extend my thanks to your staff who work tirelessly and cheerfully on your behalf:

Lee Ann Albert - Director of Membership and Education Katie Underwood – Foundation Coordinator

We also have contracted with the lobbying firm, Mapes and Mapes.

Membership The following chart presents changes in our membership by category between January 2015 and January 2016: 1/1/2016 1/1/2015 Difference Active 895 883 +12 Supporting (Includes Non- 4 2 +2 FP) Resident 215 207 +8 Student 623 512 +111 Life 76 75 +1 Inactive 4 4 0 Total 1817 1683 +134

Our Active membership has grown by 23.34% over the last 10 years. We have increased membership in all categories except Inactive membership.

Overall membership has increased by 5.68% in the past 5 years.

Our 2015 Active Member retention rate was 94.1% - slightly higher than in 2014. The National Active Member Retention is 94.2%.

For 2015 we converted 82.6% of our Resident Membership to Active (residency completion 2014). Our Resident membership has increased by 12.57% over the last five years.

Retention rate of 2015 New Physicians is 91.0%. AAFP retention rate is 88.3%.

The AAFP estimates that we have 75.0% of the market share in Louisiana. The national average is 76.5%.

48 Report of Executive Vice President, continued

General Assembly – July 8, 2016 – Destin, FL

We continue to reach out to residents and students to foster early and continued participation and leadership opportunities. We have reached out to each resident program for a faculty contact as well as to the program coordinators in hopes of improving communications with the programs and support for residents. We also offer a discount to residents on state dues their first year out of residency to help promote retention in the LAFP.

Finances Your finances remain strong, and as we approach the mid-point in the year we are poised to have one of our strongest financial years in the last several due to performance in several key areas:  Our membership numbers are at an all-time high (see the membership report for more details) and will provide the strongest dues revenue in our history in the coming year. At a time when we know that the practice environment is challenging at best, family physicians in the state continue to look to the LAFP and AAFP as a critical resource, and more of them have voted “yes” with their dues dollars than ever before.  We have active projects and strong prospects in both the CME and Practice Management and Transformation areas.

A report of our auditor, Duplantier, Hrapmann, Hogan & Maher, LLP, CPAs, will provided in a separate report to the membership later in the Fall.

Advocacy Our Advocacy efforts continue to produce results and serve the interests of members and their patients. We have remained actively engaged in aggressive advocacy across a wide spectrum of policy issues. We have worked closely in conjunction with other medical societies in joint advocacy on matters of general concern to the medical community.

We were successful in defeating a bill that would have allowed nurse practitioners to practice without a collaborative practice agreement with a physician. The bill passed in both Health and Welfare Committees and on the Senate floor. The bill was never heard on the House floor due to the opponent not having enough votes. The nurse practitioners made several attempts to get legislators to change their votes, but were unsuccessful due to the overwhelming number of contacts that were made by the physician community. We could not have done this without you and thank you for taking the time to respond to all of the action requests.

Our advocacy efforts on behalf of our members and their patients continue to grow more coordinated across government affairs, public relations, and the private sector. The work we do would not be possible without the work of the dedicated physician leaders who give of their time for everything from attending board and committee meetings (and even this General Assembly) to sitting for what often seems like endless hours in the Capitol waiting to provide testimony before legislators. It would also not be possible without the talents of a professional staff second to none in LAFP family. The LAFP is strong because of you and poised to grow even stronger, and a strong LAFP will ultimately be a driving force in changing the primary care practice environment in our state to one that produces the physicians we need today and tomorrow, and retains those physicians throughout their long, prosperous, and happy careers.

Education We continue to produce excellent educational programs under the leadership of our Education Committee and the direction of our education director, Lee Ann Albert. Our Education Committee is considering changes in our out of state annual assembly. We have held the out of state meeting in Destin for the past several years. Attendance has varied significantly in recent years and costs have increased. The Committee considered options to increase attendance and reduce costs and decided to continue the out of state conference in Destin, Florida in 2018.

49 Report of Executive Vice President, continued

General Assembly – July 8, 2016 – Destin, FL

Communications Our quarterly journal, The Louisiana Family Doctor, A Journal of the LAFP, continues to receive very positive support from readers and advertisers. I serve as the editor of the journal, along with our editorial board comprised of Dr. Michael Williams, Dr. Derek Anderson, Dr. Alan LeBato, Dr. Brian Elkins, and Dr. Tobe Momah Education Committee Chair, who have produced consistently high quality issues.

Our weekly electronic newsletter, LAFP Weekly Family Medicine Update, is our principle vehicle for communicating current and breaking news. This newsletter is sent out every Tuesday to all LAFP members. Our staff has been excellent at maintaining our social media presence with regular meaningful and promotional content with both our Facebook and Twitter accounts. If you have not liked our Facebook page or do not follow us on Twitter, I encourage you to do so.

Website/Social Media We are continuing to improve the LAFP and just completed a complete redesign in January of 2015. Last year the staff began discussions centered on enhancements to gain greater attention to the website such that it may remain up to date and prove useful for members, residents and students.

The Career Center –FP Jobs Online with Job Target has been in place for two years. It provides for broader reach and more royalty income. The use of this site remains suboptimal, however. Discussions regarding the possible optimization of this site occurred but no formal process has been decided on at this time.

Our facebook page, www.facebook.com/lafamphysicians, has nearly 600 followers. Posts relevant to health care in Louisiana and nationally are made several times a week by LAFP staff. Membership welcomes comments and suggestions from members and prospective members in this forum.

We continue our @lafp_familydocs twitter handle, with nearly 200 followers, including key AAFP leadership as well as Family Medicine publications and organizations interested in keeping an eye on what LAFP has to say. Members are encourage to contribute using our handle @lafp_familydocs or hash tag #lafp_familydocs.

Leadership We have continued to support delegates to the Southeastern Family Medicine Conference, the Annual Chapter Leader Forum (ACLF), the National Conference of Constituency Leaders (NCCL) and the National Conferences of Resident and Student Members. These important regional and national conferences are consistent sources of leadership development for Academy members.

Resident & Student Activities We have continued to support resident and student activities within the Academy. Our primary commitment has been financial subsidies for our resident and student members to attend LAFP and AAFP meetings. We also encourage resident and student members to serve on our committees and to participate in our Assembly.

Governance Our committee structure continues to provide an effective and efficient vehicle for member involvement in directing the affairs of the Academy. More than 70 members served on committees this past year. Our committees dealt with a broad range of issues and concerns on behalf of members and were expertly managed by our team of volunteer chairs and professional staff. I appreciate the efforts of those individuals and would like to acknowledge them here:

50 Report of Executive Vice President, continued

General Assembly – July 8, 2016 – Destin, FL

Committee Chair Staff Nominations James A. Taylor, Jr., MD Ragan LeBlanc Operations Bryan Picou, MD Ragan LeBlanc Legislative and Membership Issues James A. Taylor, Jr., MD Lee Ann Albert Education Tobe Momah, MD Lee Ann Albert Resident and Student Leadership Becky Batiste/ Koby Lanclos Lee Ann Albert

I confer regularly with the president, president-elect and vice president to keep our leadership team apprised of developments that may require policy decisions. These communications also afford the opportunity for me to obtain membership perspective on issues and opportunities as they may occur.

Conclusion I greatly appreciate the leadership and commitment of Dr. Elkins. He has been accessible and active in his presidency and has represented the Academy with enthusiasm and integrity. He has contributed generously to our communications programs and has made himself available to represent us at several meetings and forums. He has been a pleasure to work with and his consistent support has been a welcome enhancement to the working environment for the entire staff. He has represented us well at state and national meetings.

Change remains a constant factor in health care and in medicine. I have observed, with increasing concern, the impact which this is having on Academy members. The dreams and aspirations which so many members had upon making the decision to become a physician and then deciding to specialize in family medicine, have been severely strained by developments in insurance, regulation and technology which have dramatically altered the practice environment and the physician-patient relationship. We have been fortunate to have leaders who have been undeterred by the stress and persistence of change. Each time we are confronted with some new policy, program or practice our leadership has marshalled the fortitude and creativity to respond. In this regard, our members are very well served by the men and women who share their commitment to Family Medicine and their concern for the patients they serve and the profession they have chosen.

We have been successful in producing quality programs with professionalism and efficiency. It is my pleasure to work with an outstanding leadership and staff and I deeply appreciate that opportunity.

So as always, I will take this annual opportunity to thank you for allowing me to serve alongside each of you over the past 10 years. It is been my pleasure to serve the Board and the membership. I remain passionate in my advocacy on your behalf, determined in my persistence to see a brighter future for family physicians in Louisiana, the LAFP and the members we serve. I am looking forward to the next 10 years.

Sincerely, Ragan LeBlanc Executive Vice President

Recommendations: None

51 Report of Officers - Speaker

General Assembly – July 8, 2016 – Destin, FL

Speakers Report - Derek Anderson, MD

No report submitted

52 Report of Officers – Vice Speaker

General Assembly – July 8, 2016 – Destin, FL

Vice-Speakers Report - Dan Jens, MD

No report submitted

53 Report of Officers - President

General Assembly – July 8, 2016 – Destin, FL

LAFP President – Brian Elkins, MD

1. This was an active year for the LAFP and it has been my honor to serve as President. The organization is blessed with a remarkable and talented group of leadership, staff, and members. During this year the following activities took place:

2. The Board of Directors met on the following dates: • August 5, 2015 in New Orleans • October 29, 2015 by teleconference

3. We held an informal strategic planning meeting with myself, Dr. Taylor, and the LAFP staff at the LAFP office in Baton Rouge on September 30, 2015 to outline goals and priorities for the year.

4. This year the LAFP staff hosted regional membership outreach social events which were very successful and provided a good outreach to both current and prospective members. I was able to attend the events in Alexandria and Shreveport. The dates of those socials were as follows: • Alexandria: November 12, 2015 • Lafayette: November 17, 2015 • Shreveport: November 18, 2015 • Monroe: November 19, 2015 • New Orleans: December 10, 2015

5. Also during this year I served as Doctor of the Day at the LAFP’s First Aid Station at the Capitol during the 2016 regular legislative session on the following dates: March 17, April 14, and May 12. I plan to continue the practice as much as possible in future years and would encourage as many LAFP members as possible to take advantage of this very positive service and networking opportunity.

6. On February 18, 2016 Executive Committee held a meeting by teleconference with Aledade which is an organization that has partnered with the Mississippi AFP to form an Accountable Care Organization. No action was taken as a result of this presentation.

7. On March 15, 2016 the Legislative Committee conducted a teleconference to review bills going into the 2016 regular legislative session.

8. The legislative session was very active and saw an unprecedented level of membership involvement in reaching out to legislators, particularly regarding Senate Bill 187 which would have provided for independent practice of nurse practitioners under certain circumstances. I commend the legislative team, led by Dr. Jim Taylor; the Mapes team; the legislative committee members; and the entire LAFP membership for a job well done. I encourage the membership to continue to pursue relationships with their legislators throughout the year to be prepared for the inevitable re-introduction of this issue next year.

9. Again, I was honored to serve the LAFP in the capacity of President for 2015-2016. The year was very positive and indeed educational for me, and I look forward to serving in other capacities in the years to come, as opportunity presents.

Respectfully submitted, Brian Elkins, MD LAFP President 54 Report of Officers – President-Elect

General Assembly – July 8, 2016 – Destin, FL

President-Elect’s Report – James Taylor, Jr., MD

The President-Elect of the Louisiana Academy of Family Physicians (LAFP) is charged with establishing and leading Academy endeavors, ensuring that these efforts are guided by and in support of the LAFP Strategic Plan.

The current LAFP Strategic Plan was enacted through the efforts of LAFP Officers, Board Members, Residency Program Directors, and Staff, who met at LAFP Headquarters on April 11, 2015. The meeting was facilitated by a representative from AAFP, our national organization. The LAFP Mission Statement was amended, and is now: “To promote and support Louisiana’s family physicians in providing excellent healthcare, service, and leadership”.

The goals stated in the LAFP Strategic Plan for 2015-2018 are organized into 5 general areas. Specific projects or tasks are placed in the most appropriate general area, although most projects/tasks involve 2 (or more) of the main 5 goals, which are: Advocacy, Practice Support, Education, Membership & Communications, and Operations.

Over the last 15 months, LAFP Officers and Staff have moved towards achieving a number of goals set forth in the Strategic Plan. Our most publicized successes have come in the field of Advocacy. In the most recent Legislative session, LAFP partnered with other medical organizations to turn back a very strong and well-funded effort to remove Collaborative Practice Agreements and allow non-physicians to practice unsupervised medicine without any involvement of the physician community. The level of collaboration among physician groups in 2016 was unprecedented. LAFP held our annual White Coat Day at the Capitol, and many physicians volunteered time at the medical station LAFP sponsors at the State Capitol. LAFP sent representatives to the AAFP State Legislative Conference in Minneapolis, the Family Medicine Congressional Conference in Washington, DC, and the AAFP Leadership Conference in Kansas City. Our Legislative team and local family physicians also sponsored an informal evening get-together for our state legislators. LAFP has most certainly enhanced our reputation as an influential force in the State Capitol, not only as a political entity, but as experts on issues surrounding primary care medicine. We have been invited to meet with high-level members of the Executive branch to discuss healthcare in general, and physician training in particular, and we fully expect to honor that invitation. The primary (and immediate) future goal in Advocacy is to increase of capacity for supporting candidates friendly to family medicine through increased PAC donations. The second immediate goal will be arranging a “summit” meeting of Louisiana physician organizations to debrief from the last session and set forth common goals and strategies for the next year.

In the area of Practice Support, LAFP has offered online resources for physicians interested in learning about MACRA and the new payment structures coming into healthcare. There is a Practice management section on the LAFP website, and a toolkit on Opioid Management has recently been made available. Areas of future focus will address Direct Primary Care, contract negotiation strategies, and development of programs for students and residents to discover and make use of support structures in LAFP and AAFP.

Our Education goals are met through CME offerings at our annual meetings and through online and hard-copy publications. This part of the Strategic Plan generally deals with maintaining fund of knowledge regarding clinical practice, including new guidelines and new pharmaceuticals. LAFP will be hosting the 2016 AAFP Southeastern Forum in New Orleans, which will give our members a fairly rare opportunity to not only earn more CME, but showcase our state organization to national and other state officials. LAFP will also be offering a DOT Examiner Recertification course, which we expect will be as successful as the initial courses we offered 2 years ago.

55 Report of Officers Continued – President-Elect

General Assembly – July 8, 2016 – Destin, FL

At the core of any successful organization is the Membership, which must be maintained and engaged through Communication; therefore, the Strategic Plan includes a section on Membership and Communication. LAFP will be asking all members for more contact information, which will be used as a foundation for a more-robust member contact system. The legislative team was effective during this last session with member engagement, but we also identified areas that must be improved, particularly with contacting members on short notice. Over the next year, LAFP will see a larger volume of consistent 2-way communication between Staff, Officers, and Membership. Our outreach programs to residency programs and medical schools have been successful over the last year, and those efforts will continue with increased support to LAFP Staff. LAFP will also build upon the new and (sometimes) young leadership that appeared in the last legislative battle, as we develop a “leadership academy” for students, residents, and new members.

Operations is the part of LAFP that we need and depend upon the most, but see the least. The LAFP Staff is experienced, motivated, persistent, and (most importantly) patient. LAFP Staff frequently gets compliments at the national level. As the workload of LAFP increases, however, the requirement for support staff will also increase. LAFP Executive Director and Staff will meet with the Executive committee on a regular basis to assess need for increased staffing. LAFP has enacted a program of gradual dues increase over the next 5 years to bring us in line with national benchmarks and to increase capacity for member services. LAFP Staff will also explore alternate venues for our Annual Meetings (member input will be greatly appreciated), and will assess demand for local/regional membership meetings.

In summation, LAFP is well on our way to fulfilling the goals of the current Strategic Plan. Our strongest, and most public, success has been in the Advocacy arena. With that success, however, comes increased expectations and responsibilities. We have been mostly passive in providing access to member needs in Education and Practice Support, which has been appropriate up to this point; we may want to ask our members if they wish for those resources to be presented in a more pro-active fashion. LAFP must continue to strengthen Membership services and Operations capacity in order to fulfill the goals we have set for ourselves.

Respectfully Submitted James Taylor, Jr., MD LAFP President-Elect

56 Report of Officers – Secretary

General Assembly – July 8, 2016 – Destin, FL

Secretary’s Report – Christopher Foret, MD

(1) The Board of Directors has met two times over the course of the year, along with being invited on several of the Legislative and Membership Issues Committee calls. The minutes of the meetings were approved and duly filed at the LAFP headquarters and are available for review upon request. The minutes from the March 2016 meeting in will be approved and filed in the usual manner and will be available after board approval in July 2016.

(2) The financial report reflecting the 2015 audit will be published on the LAFP website after it is approved by the Board of Directors in the fall.

(3) In 2015 – 2016 I attended and participated in all the LAFP Board Meetings throughout the year. As Secretary I took part in the Executive Committee conference call meetings as called.

2015-2016 Executive Committee Members: President Brian Elkins, MD President-Elect James Taylor, MD Vice President Tahir Qayyum, MD Secretary Christopher Foret, MD Treasurer Bryan Picou, MD Immediate Past President Melvin Bourgeois, MD Executive Vice President Ragan LeBlanc (staff)

LAFP continues to have unprecedented leadership at the national level including the following members: Commission on Education – James Campbell, MD Annuals of Family Medicine Editorial Advisory Board - Nicole Gentile, PhD

2016 Annual Chapter Leadership Forum and National Conference of Constituency Leaders Representatives: (4) This year was the 25th Anniversary of the AAFP’s National Conference of Constituency Leaders (NCCL). The LAFP was recognized for sending a delegation held May 5-7, 2016 in Kansas City, MO. NCCL is held annually in conjunction with the American Academy of Family Physicians (AAFP) Annual Chapter Leader Forum. NCSC delegates from Louisiana were:

Richard Bridges, MD – New Physician Representative Jody George, MD – International Medical Graduate Representative Lisa Casey, MD – Woman Representative Tobe Momah, MD – Minority Representative

Louisiana Family Physicians continue to be leaders around Louisiana such as: Ralph Abraham, MD United States House of Representatives John Fleming, MD United States House of Representatives Chris Foret Physician Representative, Patient’s Compensation Fund Mark Dawson, MD LSBME President and LAFP Representative James Taylor, MD Clinical Laboratory Advisory Committee– LSBME Louisiana Academy members that have received awards this year includes:

 Highest Achievement in Diabetes Care 2015: The Family Doctors – Shreveport  Highest Achievement in Hypertension Care 2015: Green Clinic – Arcadia

57 Report of Officers Continued – Secretary

General Assembly – July 8, 2016 – Destin, FL

 Highest Achievement in Kidney Care 2015: Bossier Family Medicine  Highest Achievement in Vascular Care 2015: The Family Doctors – Shreveport

Quality Blue Primary Care Awards

Doctor Clinic Achievement Baig, Mirza Ochsner Top Performers -- Vascular Care Barksdale, Wayne The Family Doctors Top Performers – Hypertension Care Top Performers – Diabetes Care Bella, Timothy Bella Family Medical Top Performers – Hypertension Care Brown, Andrea BRGP Plaquemine Top Performers – Diabetes Care Cash, Marion The Family Doctors Top Performers – Hypertension Care Top Performers -- Vascular Care Top Performers – Diabetes Care Gaspard, Brad Baton Rouge Family Medical Center Top Performers – Hypertension Care Top Performers -- Kidney Disease Care Top Performers -- Vascular Care Top Performers – Diabetes Care Jones, Ricky The Family Doctors Top Performers – Hypertension Care Top Performers -- Vascular Care Top Performers – Diabetes Care Kerr, Katie The Family Doctors Top Performers – Diabetes Care Lebeau, Thomas Imperial - Bayou Pines Top Performers -- Kidney Disease Care Mathis, Timothy The Family Doctors Top Performers – Hypertension Care Top Performers – Diabetes Care Mercer, Sherin The Family Doctors Top Performers – Hypertension Care Top Performers – Diabetes Care Miller, Christopher Bryan SMH Physician Network-East I-10 Top Performers – Hypertension Care Top Performers -- Vascular Care Moore, Lauren BRFMC-Livingston Top Performers – Hypertension Care Murphy, Kevin The Family Doctors Top Performers – Hypertension Care Top Performers -- Vascular Care Top Performers – Diabetes Care Patton, Charles The Family Doctors Top Performers – Hypertension Care Top Performers – Diabetes Care Primeaux, Arthur Imperial - Bayou Pines Top Performers – Hypertension Care Smith, Victoria Ochsner - Kenner Top Performers – Diabetes Care Springer, Steve Imperial-601 Dr. Michael DeBakey Drive Top Performers – Hypertension Care Taylor Jr, James BRFMC-Livingston Top Performers – Hypertension Care Theis, James Patricia Jackson MD, LLC Top Performers – Diabetes Care Vinayagam, Vasanthi Primary Care Group Top Performers – Hypertension Care Top Performers -- Kidney Disease Care Yorek, Michael Baton Rouge Family Medical Center Top Performers – Diabetes Care

58 Report of Officers Continued – Secretary

General Assembly – July 8, 2016 – Destin, FL

Alicia Ortiz First Time Student Attendee Award – AAFP National Conference Ester Hong, MD Minority Scholarship Program for Family Medicine Residents Christopher Mertens First Time Student Attendee Award – AAFP National Conference Zachary Pray, MD Tomorrow’s Leader Award Janice Dara LSU-Shreveport Michael O. Fleming, MD Award Danielle Fuselier LSU-New Orleans Gerald R. Gehringer Family Medicine Award Nicole Gentile Tulane Family Medicine Excellence Award Micah Pippin, MD Resident of Excellence Award

Communications (5) Our quarterly journal, The Louisiana Family Doctor, A Journal of the LAFP, continues to receive very positive support from readers and advertisers. I serve as the editor of the journal, along with our editorial board comprised of Dr. Michael Williams, Dr. Derek Anderson, Dr. Alan LeBato, Dr. Brian Elkins, and Dr. Tobe Momah Education Committee Chair, who have produced consistently high quality issues . (6) Our weekly electronic newsletter, LAFP Weekly Family Medicine Update, is our principle vehicle for communicating current and breaking news. This newsletter is sent out every Tuesday to all LAFP members. Our staff has been excellent at maintaining our social media presence with regular meaningful and promotional content with both our Facebook and Twitter accounts. If you have not liked our Facebook page or do not follow us on Twitter, I encourage you to do so.

(7) It has been a pleasure serving our academy.

Respectfully Submitted, Christopher Foret, MD LAFP Secretary

59 Report of Officers – Treasurer

General Assembly – July 8, 2016 – Destin, FL

Treasurer’s Report – Bryan Picou, MD

(1) As the Treasurer of the Louisiana Academy of Family Physicians, I submit the following report to the 2016 General Assembly.

(2) The role of the treasurer is to monitor the financial position and condition of the Academy and to oversee the work of our staff in preparing and maintaining the financial information that the board of directors needs to adequately fulfill its fiduciary duties to the members. In my capacity as treasurer I have been in regular communication with the Board and Executive Vice President of the Academy in reviewing financial information and making recommendations regarding the operations, budgeting and investments of the Academy. I also report on the financial condition of the Academy to the Operations Committee and to the board.

(3) The Academy operates on a calendar fiscal year. We generally experience our greatest income in the first and fourth quarters because dues constitute our greatest source of revenue and dues are assessed in the fall. Most members pay their dues between November and March.

(4) We have an annual audit conducted by Duplantier, Hrapmann, Hogan & Maher, LLP. Their opinion has remained that “the financial statements present fairly in all material respects, the financial position of the Louisiana Academy of Family Physicians. The LAFP net assets and cash flows have remained in accordance with accounting principles generally accepted United States of America.” The audit for 2015 has been scheduled for August, 2016 after Annual Assembly.

(5) This report examines our finances as of July 1, 2016. Our formal financial statement consists of a profit & loss statement, which illustrates our operational status for the current fiscal year, accounts payable and accounts receivable.

Operating Funds (6) As of 7/01/2016 we have the following balances in our operating and investment accounts. A. LAFP Academy As of 7/01/2015 the Academy had $370,188.99 cash on hand. Therefore the Academy is currently in sound financial shape. B. LAFP Foundation The Foundation had $83,845.50 on hand as of 7/01/2016. C. LaFamPac LaFamPac had $4,965.97 on hand as of 7/01/2016.

(7) We have a total of $459,000.46 on hand to support operations through the remainder of the year.

Revenues (8) We have received $232,093.78 in dues. This is 89% of the 2016 dues budget of $259,815.00. Total revenues are $490,912.50.

Expenses Expenses through July 1st total $189,661.65 which is 39% of the $489,890.04 budget for operating expenses.

60 Treasurers Report, continued

General Assembly – July 8, 2016 – Destin, FL

Conclusion (9) Overall, the Academy is financially stable with an adequate cushion of capital to cover expenses for the next 12 months. The LAFP is financially stable and no significant financial problems are anticipated in the near future. The Executive Vice President and the Board of Directors will continue to monitor expenses in order to maintain the good financial position of the Academy.

(10) I want to express my appreciation of the attention to detail of our staff in managing the Academy’s finances particularly our EVP, Ragan LeBlanc who share primary responsibility for our overall financial management. Additionally, our Membership and Education Director, Lee Ann Albert, and Foundation Coordinator, Katie Underwood, who has worked very hard to contain costs in our education programs and to produce profits that have helped to make our educational programs affordable to members.

(11) I would also like to express my gratitude to the membership of the Academy for allowing me to serve as treasurer. I believe we are in a good financial position and are prepared to advance the interests of our members in the coming year.

Respectfully Submitted, Bryan Picou, MD Treasurer LAFP

61 Report of Officers – AAFP Delegates Report

General Assembly – July 8, 2016 – Destin, FL

AAFP Delegate Report Delegates Marguerite “Cissy” Picou, MD Russell Roberts, MD

Alternate Delegates Bryan Picou, MD James Campbell, MD

(1) Louisiana’s delegates and alternates to the 2015 American Academy of Family Physicians Congress of Delegates, Marguerite Picou, MD, Bryan Picou, MD, James Campbell, MD and Russell Roberts, MD attended the Congress sessions held September 28-30 at the Hyatt Regency Denver in Denver, CO.

(2) During the COD's reference committee hearings on Sept. 28, AAFP members will have a chance to share their views about various resolutions to be considered and help shape new AAFP policies. Delegates voted on those resolutions in subsequent business sessions. Then, on Sept. 30, the delegates elected AAFP officers and members of the Board of Directors.

(3) Delegates to the 2015 Congress of Delegates had other topics they tackled, which included immunization exemptions and student loan repayment. After lengthy reference committee testimony and continued debate during the Sept. 29 business session, delegates overruled the reference committee's referral recommendation and adopted a resolution that directed the Academy to advocate for graduated loan repayment programs. Delegates also adopted a measure that looked to the Academy to support legislation that would eliminate nonmedical immunization exemptions for those participating in federally funded educational programs, including Head Start. In addition, delegates adopted a number of substitute resolutions on various clinical and public health issues, directing the AAFP to support implementation of programs for first-responders and nonmedical personnel to administer naloxone; advocate for a federally funded adult immunization program that would include administration of vaccines recommended by the Advisory Committee on Immunization Practices that are given in the primary care office; and support the inclusion of U.S. territories and Puerto Rico in all aspects of the Patient Protection and Affordable Care Act, including funding.

(4) Dr. Campbell served on the Credentials Committee. Dr. Roberts served on the Bylaws Workgroup.

(5) New officers elected by the Congress include: • President-Elect – John Meigs Jr., M.D. (Brent, AL) • Speaker – Javette Orgain, M.D., M.P.H. (Chicago • Vice Speaker – Alan Schwartzstein, M.D. (Oregon, WI)

(6) AAFP Board of Directors: • Jack Chou, MD, FAAFP (Pomona, CA) • Robert A. Lee, MD (Iowa City, IA) • Michael L. Munger, MD (Kansas City, MO)

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General Assembly – July 8, 2016 – Destin, FL

(7) New Physician board member: • Marie-Elizabeth Ramas, M.D. (Mount Shasta, CA)

(8) AAFP Board of Directors: • Jack Chou, MD, FAAFP (Pomona, CA) • Robert A. Lee, MD (Iowa City, IA) • Michael L. Munger, MD (Kansas City, MO)

(9) New Physician board member: • Marie-Elizabeth Ramas, M.D. (Mount Shasta, CA)

(10) Resident board member: • Richard Bruno, M.D., M.P.H. (Baltimore, MD)

(11) Student board member: • Tiffany Ho, M.P.H. (Baltimore, MD)

(12) The 2016 AAFP Congress of Delegates will be held in September 19-21, 2016 in Orlando, FL

Respectfully Submitted, Marguerite “Cissy” Picou, MD Russell Roberts, MD James Campbell, MD Bryan Picou, MD

63 Resident and Student Leadership Committee

General Assembly – July 8, 2016 – Destin, FL Resident and Student Leadership Committee Report

(1) The Student and Resident Recruitment Committee met three times this year via conference calls. Among the relevant topics addressed several ways in which to reach students and residents at our meetings and other venues. The following are the highlights that the Committee worked on this past year:

LAFP 2015 Annual Assembly Student Track (2) The Committee reviewed the evaluations from the Student and Resident Track details for the Annual Meeting. The committee agreed that all the sessions planned were very good. Thoughts for the Resident/Student Track in 2017 include more hands-on workshops and joint sessions. The group discussed closing both of the tracks with a Louisiana-only residency fair and social. All agreed it was a success and should be included for 2017.

LAFP White Coat Day (3) The legislative effort of White Coat Day was reviewed by the committee as a day to promote Family Medicine and family physicians to the state legislature. White Coat Day was held on Wednesday, May 18, 2016 at the Capitol. This event was a valuable and successful day for the LAFP. The residency programs from around the state set up various screening booths for the White Coat Day Health Fair in the State Capitol Rotunda. Including: • Body Mass Index Screening- Lake Charles Family Medicine Residency Program • Blood Pressure Screening- Family Medicine Residency Program-Bogalusa and Family Medicine Residency Program Ochsner Medical Center • Kenner Glucose Screening- Baton Rouge General Family Medicine Residency Program and East Jefferson Family Medicine Residency

LAFP Student and Resident Elections (4) The student and resident elections were held and the following individuals were elected:

Delegate Positons Delegates

Resident Delegate to LAFP Board of Directors James Robinson, MD Alternate Resident Delegate to LAFP Board of Directors Jason Schrock, MD Student Delegate to LAFP Board of Directors Koby Lanclos Alternate Student Delegate to LAFP Board of Directors Open

Resident Delegate to LAFP General Assembly Deana Blanchard, MD Resident Alternate Delegate to LAFP General Assembly Open Student Delegate to LAFP General Assembly Open Student Alternate Delegate to LAFP General Assembly Open

Resident Delegate to AAFP National Conference Ronald Slipman, MD Alternate Resident Delegate to AFFP National Conference Open Student Delegate to AFFP National Conference Khine Sein Alternate Student Delegate to AAFP National Conference Michael Bacon

AAFP National Conference (5) The LAFP will also have a booth during the conference with the following residency programs: Baton Rouge General Medical Center, East Jefferson, Alexandria, Bogalusa, Kenner, Lake Charles, Monroe, and Shreveport.

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LAFP Resident Leadership Award (6) The committee submitted a resolution to the 2015 LAFP General Assembly to establish a Resident Leadership Award. All residency programs were contact to submit nominations for the first Resident Award of Excellence. The Lafayette Residency Program nominated Danielle Duhon, MD, and the Alexandria Residency Program nominated Micah Pippin, MD. The nomination packets were reviewed by the Foundation Board of Directors. Dr. Pippin was chosen as the recipient for 2016.

Recognition of Volunteers on behalf of the Committee (7) The Committee would like to acknowledge all who have advocated for family medicine to groups throughout the state, as part of a family medicine interest group meeting. The following members have served on this Committee:

Resident Members Program/School Becky Batiste Bogalusa Deana Blanchard EJGH Brian Callihan BRGMC Brandon Gill Alexandria Smita Prasad BRGMC Ryan Rhodes Lake Charles Clayton Runfalo BRGMC Jason Shrock BRGMC Ronnie Slipman EJGH William Wise Shreveport

Student Members Program/School Student Members Program/School Michael Bacon New Orleans Van Kim Nguyen New Orleans Daniel Bonnette Shreveport Robert Nuss New Orleans Richie Diaz Shreveport Cara Permeter Shreveport Joey Dressler Shreveport Payton Olson Shreveport Nikki Gentile Tulane Khine Sine Tulane Ethan Hundley Shreveport Taylor Shepherd Shreveport Koby Lanclos Shreveport Emily Songer Shreveport Keanan McGonigle Tulane Christopher Trosclair Shreveport Aimee Moran New Orleans Kristen Whalen Tulane Robert Nuss New Orleans

Respectfully Submitted for the Committee by, Lee Ann Albert Director of Membership and Education

65 Education Committee Report

General Assembly – July 8, 2016 – Destin, FL

Committee on Education Tobe Momah, MD - Chair

Committee Meetings (1) The Education Committee convened on the following date: September 9, 2015. The meeting was held through conference call and electronic communications. Next year’s Annual Assembly will be held August 3-6, 2017 at the Roosevelt, New Orleans.

Activity Planning (2) We have also been active in discussing many possible CME topics, abstracts received from prospective speakers, and other issues relevant to the Commission via email listserv. (3) The Education a Committee during the past year was fundamental in the planning of the following activities. • 2016 Annual Scientific Assembly • 2016 Southeastern Forum Meeting • 2017 Annual Scientific Assembly • Department of Transportation Workshop • Collaboration with other organizations to offer diverse CME offerings

(4) The Committee suggested titles and possible speakers for the Annual Convention CME program. We also discussed possible procedural workshops and other ideas for breakout sessions.

Major Initiatives DOT Workshops (5) In 2013 the Federal Motor Carrier Safety Administration announced a new program called the National Registry of Certified Medical Examiners (National Registry) which dictated that all commercial drivers be examined by a certified medical professional by May 2014. This also meant that only medical examiners that had completed training and successfully passed a test on Federal Motor Carrier Safety Administration's (FMCSA) physical qualification standards by May 2014 would be listed on the National Registry.

(6) In 2015, the LAFP offered a DOT Medical Examiner Training Course. The training was held on July 18, 2015 at the LAFP office. The course, led by Dr. Esther Holloway, offered clinical guidelines that physicians and other clinicians need to follow in order to conduct updated DOT physicals.

(7) The training also offered practical tips on completing the required documentation needed to certify a Commercial Motor Vehicle (CMV) driver. At the end of each course, faculty work with attendees to register on the National Registry System to receive their unique identifier needed to register for the federal exam.

CME Funding and Reporting Continue to Affect Change (1) The Committee was continually kept abreast of changing funding trends in CME and discussed how the changes factored into the LAFP’s CME programs.

(2) With the current economic state and industry funding dwindling each year, the Committee discussed ways to diversify the LAFP’s funding sources for CME and continue to offer cutting-edge educational programming to members. The Committee continues to partner with multiple education companies to offer varied educational agenda.

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(3) Disclosure of the financial relationships between industry and healthcare providers is not intended to signify an inappropriate relationship, and Open Payments reporting does nothing to prohibit such transactions. However, these relationships may also influence research, education, and clinical decision-making in ways that compromise clinical integrity and patient care and may potentially lead to increased healthcare costs.

(4) The Academy will continue to follow the ever-changing reporting process and keep our members up-to-date on the current laws and how they affect the individual and the way CME is funded.

2016 Annual Scientific Assembly (5) July 7-10, 2016 marked the LAFP’s 69th Annual Scientific Assembly and Exhibition in Destin, FL. Hosting approximately 75 family physicians and other health care professionals at the Baytowne Conference Center at the San Destin Golf and Beach Resort, the LAFP offered up to 15 CME credit and a myriad of CME lectures.

2017 Annual Scientific Assembly (6) In 2017 the LAFP’s 2016 Annual Scientific Assembly will be offered on August 3-6, 2017. This year we will host the meeting at the Roosevelt Hotel in New Orleans. This year educational programs will include a variety of CME lectures.

Summary (1) Thanks to our Education Committee for their participation and support of the LAFP educational initiatives.

(2) The continued goal of the Education Committee is to make the LAFP the “Premier Provider” of CME for our members.

Respectfully submitted, Tobe Momah, MD 2015 - 2016 Education Committee Chair

67 Legislative and Membership Issues Committee

General Assembly – July 8, 2016 – Destin, FL

Legislative Report James A. Taylor, Jr, MD – Chairman, Legislative Committee

The 2016 Regular Louisiana Legislative Session began on Monday, March 14, 2016 and adjourned on Monday, June 6th. The LAFP Legislative Committee reviewed a list of 1,644 bills—1,167 in the House and 477 in the Senate, as well as 760 resolutions – 410 in the House and 350 in the Senate - that were filed during this legislative session. The LAFP decided to track a total of 148 bills and resolutions. The House and Senate debated several complex healthcare and scope of practice issues.

This was a relatively busy year for the LAFP, and there were a number of potentially harmful bills that were addressed to help ensure that they not pass, and a few others that we supported as they became law. Your legislative team worked diligently to protect the interests of family physicians and our patients. Thanks to Mapes and Mapes for their continuing invaluable efforts this year, to our (mostly) tireless LAFP office staff, and to our Committee members who actively participated in the development of our positions. We, the LAFP, are well served by these members and staff.

Our legislative committee met before and during the session to set priorities and define specific positions on bills that we were following. We worked effectively on issues with other organizations, both healthcare and non- healthcare, and communicated with the Louisiana State Medical Society, LA Chapter of the American Academy of Pediatrics and Medicine Louisiana on several bills. The committee met on several occasions and asked for opinions and guidance by email when needed when emergent issues arose. Additionally the LAFP held a successful legislative social during the session that was well attended by legislators and LAFP members.

In the past four legislative sessions, family physicians have been threatened with scope of practice expansion by allied health professionals. Several bills attempting to expand the scope for nurse practitioners and physical therapist were presented before the legislature. Bills related to the nurse practitioners were successfully defeated, either directly or indirectly, thanks to hard work, diligence, and collaborative efforts. We were able to help organize the medical legislative teams into a force that is now relevant to the legislative process. Most of our members understand what kinds of precedents are being established by these kinds of bills, and each year this threat continues and shows no inclination of changing. They will not stop until we make them stop.

Please refer to the Legislative Summary for further details on the bills that we followed below.

Legislative Socials In 2016, the LAFP held several membership socials in several areas of the state to update members on the upcoming legislative session and allowed members to ask questions of the LAFP leadership. These socials were planned with LAFP staff, the LAFP Committee on Legislation and Board of Directors to introduce members to their role in the legislative process and encourage members to participate in the Louisiana legislative session as a key contact or witness.

White Coat Day On Wednesday, May 18th the LAFP held the 2016 White Coat Day at the Capitol. This event was a valuable and successful day for the LAFP.

The residency programs from around the state set up various screening booths for the White Coat Day Health Fair in the State Capitol Rotunda. Including:

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• Blood Pressure Screening- Kenner Family Medicine Residency Program and Bogalusa Family Medicine Residency Program. • Glucose Screening- Baton Rouge General Family Medicine Residency Program and East Jefferson Family Medicine Residency • Body Mass Index – Lake Charles Family Medicine Residency Program

Here, our physicians were able to put their advocacy skills into practice. Legislators were seen throughout the afternoon by our residents and physicians while hearing concerns and feeling the presence of Family Medicine as a solidified unit.

The day as a whole was a great success, and we greatly appreciate all of our members who took the time to participate and help strengthen the voice of Family Physicians in Louisiana. If you were unable to attend this year, be on the lookout for 2017 dates!

Family Medicine Legislative Champion of the Year The Legislative Committee will recognize three legislators – two senators and a representative for their representation of health care issues and support of the LAFP during the 2016 legislative session. They will be presented with a recognition plaque during the Awards and Installation program to be held on Saturday, July 9th.

Individual Involvement – Family Physician of the Day I want to express my gratitude to the members of the legislative committee for their time, advice, and expertise. It was a very active and involved group this year. Thanks also to those LAFP members who volunteered time as Family Physician of the Day, which had the highest number of member participants in our tenure at that facility. There is no way to overstate the value this program brings to our Academy, and to the House of Medicine in general, in terms of our profile, our reputation, and our mission. The time those members give when leaving their practices, on behalf to our colleagues and our profession, is precious and is appreciated as such. Legislators and Capitol staff continue to provide feedback on how much they appreciate our presence through the Family Physician of the Day program. The following members volunteered their time during the 2016 Legislative Session:

Dr. Brian Callahan Dr. Lisa Casey Dr. Phillip Ehlers Dr. Brian Elkins Dr. Alan LeBato Dr. Smita Prasad Dr. Maryann Sandy Dr. Jason Schrock Dr. James Taylor

LAFP also extends warm thanks and appreciation to our nursing staff at the Capitol, Pat Rusk, RN and Errol McCrae, RN, who are there every day whether or not a doctor comes in.

Your LAFP Legislative Affairs Committee The following LAFP members serve on the Legislative and Membership Issues Committee:

Chris Achee, MD Chris Foret, MD Joseph Nida, MD Richard Bridges, MD Indira Gautam, MD Bryan Picou, MD Eldridge G. Burns, MD Wayne Gravois, MD Marguerite “Cissy” Picou, MD James Campbell, MD Alan LeBato, MD M. Tahir Qayyum, MD Lacey Cavanaugh, MD Edward Martin, Jr., MD Nicholas Seelinger, MD Mark Dawson, MD Meredith Maxwell, MD Carol Smothers, MD Phillip Ehlers, MD Patrick Moore, MD Zeb Stearns, MD

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LAFP Tracked Bills for the 2016 Session House Bills Bill Author Summary LAFP Position Notes

Monitor 06-05-16 H House APPROPRIATIONS: Provides for the adopted the HB1 HENRY ordinary operating expenses of state conference report government for Fiscal Year 2016-2017 (Vote: Y: 63/N: 38) Monitor 02-08-16 H Referred PROCUREMENT: Provides for the to House Committee HB71 COX extension of a Medicaid fiscal on House intermediary services contract Appropriations STUDENT/HOME STUDY: Removes Oppose requirement that certain students in 05-24-16 H HB87 AMEDEE approved home study programs provide Voluntarily Deferred documentation of immunization against in Committee House meningococcal disease Education Monitor 05-26-16 S APPROPRIATIONS: Provides for the Voluntarily Deferred HB105 HENRY ordinary operating expenses of state in Committee Senate government for Fiscal Year 2016-2017 Finance Monitor 04-07-16 H MEDICAID: Requires legislative approval Voluntarily Deferred HB106 JAY MORRIS of certain changes in Medicaid eligibility in Committee House standards Health and Welfare PUBLIC MEETINGS: Prohibits Monitor/Oppose communication among a quorum of the members of a public body unless such 05-11-16 H Failed to

HB162 EDMONDS communication is contemporaneously pass (Vote: Y: 18/N: visible or audible to the public unless the 77) public body is in an executive session authorized by law Oppose MEDICAID: Requires the Dept. of Health 04-07-16 H and Hospitals to institute Medicaid cost Voluntarily Deferred HB170 TALBOT containment measures to the extent in Committee House allowed by federal regulations Health and Welfare CHILDREN/NEWBORNS: Requires birthing Monitor facilities to offer information to parents of HB171 HODGES newborns on shaken baby syndrome and 06-06-16 G Sent to sudden infant death syndrome the Governor Oppose 04-07-16 H MEDICAID: Requires cost sharing for Voluntarily Deferred HB173 HAVARD certain Medicaid-covered services and in Committee House dedicates revenues derived thereof Health and Welfare

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MALPRACTICE/MEDICAL: Provides Monitor relative to transmittal of certain notices HB195 JENKINS required pursuant to medical malpractice 08-01-16 G Effective - law Act 275 Support 06-05-16 H House HEALTH/SMOKING: Prohibits the use of rejected the HB218 HOFFMANN tobacco products on elementary and conference report secondary school property (Vote: Y: 17/N: 81) Monitor 04-19-16 H PRESCRIPTION: Provides for a liberative Voluntarily Deferred HB282 CONNICK prescriptive period of two years in Committee House Civil Law HEALTH/CHILDREN: Requires a child Monitor 04-21-16 H

HB302 LEGER wellness evaluation for each student Substituted by - see entering kindergarten or sixth grade HB 1144 Monitor 03-02-16 H Referred MEDICAID: Requires that La. Medicaid to House Committee HB305 NORTON eligibility standards conform to those on House Health and established by the Affordable Care Act Welfare Oppose MEDICAID: Provides for cost containment, 04-07-16 H cost sharing, and long term services and Voluntarily Deferred HB309 BACALA supports in the Medicaid managed care in Committee House program Health and Welfare Oppose MEDICAID: Requires a copayment in the 04-07-16 H Medicaid program for all nonemergency Voluntarily Deferred HB324 M.JOHNSON services provided by a hospital emergency in Committee House department Health and Welfare Monitor 04-19-16 H Removed BOARDS/COMMISSIONS: Abolishes the from hearing HB339 SCHRODER Health Education Authority of Louisiana 04/20/16 - House Education Monitor PUBLIC OFFLS/EMPS: Reduces the salary 03-02-16 H Referred of certain public employees and officials to House Committee HB360 JAY MORRIS whose compensation exceeds a certain on House amount by ten percent Appropriations Monitor 04-26-16 H STATE EMPLOYEES: Requires certain Voluntarily Deferred HB362 RICHARD reductions in the number of positions in in Committee House the executive branch of state government Appropriations Monitor 03-03-16 H Referred CONSTITUTION/CONVENTION: Provides to House Committee HB375 CROMER for calling a constitutional convention on House and Governmental Affairs

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ABORTION: Extends the mandatory Monitor waiting period between certain required HB386 HOFFMANN pre-abortion procedures and the 08-01-16 G Effective - performance of an abortion Act 97 STUDENTS: Authorizes the state Dept. of Support Education and the Dept. of Health and

HB402 P.SMITH Hospitals to survey students regarding certain risk behavior associated with 05-16-16 S Failed to chronic health conditions Pass in Committee. Oppose INSURANCE/HEALTH: Provides relative to 04-27-16 H reimbursement of noncontracted Voluntarily Deferred HB412 THIBAUT healthcare providers of emergency in Committee House medical services Insurance Oppose MEDICAID: Directs the Department of 04-07-16 H Health and Hospitals to institute cost Voluntarily Deferred HB435 HODGES sharing for certain Medicaid-covered in Committee House services Health and Welfare PHYSICIANS: Provides relative to Support

HB441 JACKSON conditions for physician participation with 08-01-16 G Effective - Medicaid managed care organizations Act 250 Oppose - Red MEDICAID: Requires copayments for 03-03-16 H Referred card Medicaid-covered physician visits and to House Committee HB461 AMEDEE nonemergency services delivered in on House Health and hospital emergency rooms Welfare Monitor 04-06-16 H HEALTH CARE: Provides for Medicaid Voluntarily Deferred HB474 HOFFMANN expansion through a demonstration in Committee House waiver program Health and Welfare HEALTH SERVICES: Provides relative to Support

HB480 JACKSON the practice of telemedicine in licensed 05-26-16 G Effective - healthcare facilities Act 252 MEDICAID: Provides relative to Monitor 04-14-16 H

HB487 R.JOHNSON reimbursements by Medicaid managed Recommitted House care organizations for prescription drugs Appropriations ABORTION: Provides relative to Monitor

HB488 JACKSON qualifications of physicians who perform 08-01-16 G Effective - elective abortions Act 98 Monitor 03-03-16 H Referred HEALTH/CANCER: Provides for access by to House Committee HB489 N.LANDRY patients to mammography and ultrasound on House Health and reports Welfare

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Oppose 04-07-16 H MEDICAID: Authorizes the collection of Voluntarily Deferred HB492 MCFARLAND certain copayments in the medical in Committee House assistance program Health and Welfare Oppose ACUPUNCTURISTS: Provides for the 05-17-16 S Not Heard HB496 JAY MORRIS practice of acupuncture in Committee Senate Health and Welfare MENTAL HEALTH: Requires the Monitor Department of Health and Hospitals to

HB497 NORTON implement the Medicaid health home 05-11-16 H option for persons with serious mental Substituted by - see illness HB 1164 HEALTH CARE/FACILITIES: Institutes a Monitor

HB498 POPE moratorium on new pediatric day health 07-01-16 G Effective - facility licenses Act 254 Oppose 04-07-16 H MEDICAID: Establishes certain provider Voluntarily Deferred HB517 BACALA fees within the Louisiana Medicaid in Committee House program Health and Welfare Monitor 04-13-16 H DRUGS/PRESCRIPTION: Provides for Voluntarily Deferred HB531 FALCONER access to prescription monitoring in Committee House information by specialty courts Health and Welfare CIVIL/DISCOVERY: Provides relative to Monitor

HB537 GAROFALO applicable fees and costs incurred for the 06-06-16 G Sent to production of records the Governor MEDICAID: Provides relative to fees Oppose 3- 3-16 H Referred to imposed within the Medicaid program on House Committee on HB551 R.JOHNSON healthcare providers, facilities, and House Health and services Welfare ACUPUNCTURISTS: Provides for the Monitor 06-06-16 G Sent to HB557 JAY MORRIS licensing of acupuncturists the Governor Oppose 04-07-16 H MEDICAID: Requires the Department of Voluntarily Deferred HB566 RICHARD Health and Hospitals to institute certain in Committee House Medicaid cost containment measures Health and Welfare HEALTH SERVICES: Provides relative to Oppose 06-06-16 G Sent to HB570 SCHRODER the practice of telemedicine the Governor Oppose 06-02-16 G Sent to DIETITIANS: Provides relative to the HB579 R.JOHNSON the Governor - Act delivery of nutrition services 415 DIETITIANS: Provides relative to the Monitor 06-02-16 G Sent to

HB595 R.JOHNSON delivery of nutrition services through the Governor - Act telehealth 417

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FUNDS/FUNDING: Prohibits entities that Monitor

HB606 HOFFMANN perform abortions from receiving public 06-02-16 G Effective - funding for any purpose Act 304 Oppose 03-04-16 H Referred NURSES/REGISTERED: Provides relative to to House Committee HB620 WILLMOTT advanced practice registered nursing on House Health and Welfare PHYSICAL THERAPISTS: Eliminates Oppose 03-04-16 H Referred restrictions on performance of physical to House Committee HB623 LEBAS therapy services without a prescription or on House Health and referral Welfare CONTROLLED SUBSTANCES: Adds Monitor substances to Schedules II and IV of the HB688 LEBAS Uniform Controlled Dangerous Substances 08-01-16 G Effective - Law Act 62 FEES/LICENSES/PERMITS: Revises fee Monitor amounts for facilities and providers Substitute adopted HB699 STOKES licensed by the Dept. of Health and on the House floor. Hospitals Became HB1158 FEES/LICENSES/PERMITS: Provides Monitor relative to fees assessed for certain 05-04-16 H Returned HB700 STOKES functions performed by the office of to the calendar - public health subject to call INSURANCE/HEALTH: Prohibits certain Support 04-14-16 H

HB705 BROADWATER contractual provisions in provider Substituted by - see contracts with health insurance issuers HB 1140 Monitor 04-05-16 H Removed INSURANCE/HEALTH: Provides for the from hearing HB754 TALBOT time of modification of drug coverage by 04/06/16 - House health insurance issuers Insurance MEDICAID: Provides relative to the Oppose 05-04-16 H

HB761 STOKES Medicaid recovery audit contractor Substituted by - see program HB 1157 Monitor MENTAL HEALTH: Provides relative to 04-12-16 H Removed referrals of certain Medicaid enrollees for from hearing HB762 JACKSON mental health counseling or treatment by 04/13/16 - House managed care providers Health and Welfare HUMAN SERVICES: Authorizes and Monitor

HB763 CARPENTER provides for mental health emergency room extensions 06-07-16 G Enrolled Monitor 05-17-16 H MEDICAID: Provides for implementation Voluntarily Deferred HB790 LEGER of a Medicaid managed long term services in Committee House and supports system Health and Welfare

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Oppose 03-29-16 H Removed DRUGS/CONTROLLED: Provides from hearing HB791 MORENO limitations on prescriptions for opioid 03/30/16 - House drugs Health and Welfare MASSAGE THERAPISTS: Provides relative Oppose 06-06-16 G Sent to HB792 ADAMS to the regulation of massage therapists the Governor HUMAN REMAINS: Prohibits post- Monitor abortion harvesting of fetal remains and HB815 STOKES requires burial or cremation of such remains 06-07-16 G Enrolled INSURANCE/HEALTH: Prohibits Monitor assessment of a fee relating to the health 04-13-16 H

HB824 LEBAS insurance claims adjudication verification Voluntarily Deferred process on any healthcare provider or in Committee House facility Insurance INSURANCE/HEALTH: Provides a time Monitor frame for appeals of adverse

HB849 R.JOHNSON determinations made regarding the 04-28-16 H medical necessity of prescription drugs Substituted by - see and intravenous infusions HB 1151 Monitor Provides relative to background checks for 05-26-16 G Sent to Willmott, persons applying for licensure by the La. the Governor - Act

HB 918 Tom(R) State Board of Practical Nurse Examiners. 368 Monitor 04-27-16 H Provides relative to eligibility for a license Voluntarily Deferred to produce or dispense therapeutic in Committee House

HB 920 Talbot, Kirk(R) marijuana. Health and Welfare Monitor Hensgens, Revises provider fees assessed on nursing Bob(R) Mills, homes by the Department of Health and 06-06-16 G Sent to

HB 922 Fred(R) Hospitals the Governor Monitor Provides relative to the transport of a 04-26-16 H Removed patient to a mental health treatment from hearing facility under a physician's emergency 04/27/16 - House

HB 930 Pylant certificate. Health and Welfare Provides relative to the investigation and Monitor adjudication of complaints against 05-17-16 S Failed to

HB 946 Connick physicians. Pass in Committee. Provides relative to the investigation of Monitor Jackson, violations by the Louisiana State Board of 04-21-16 H

HB 955 Katrina(D) Medical Examiners. Withdrawn

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Monitor Requires educational or marketing 05-03-16 H materials for prescription drugs directed Voluntarily Deferred Cromer, to healthcare providers to include price in Committee House

HB 961 Greg(R) information. Health and Welfare Monitor Requires adult residential care providers and nursing homes to disseminate information on shingles and pneumonia 08-01-16 G Effective -

HB 969 Cox, Kenny(D) immunizations. Act 155 Provides relative to functions and Monitor 05-05-16 H Miller, composition of the La. State Board of Substituted by - see

HB 979 Dustin(D) Nursing. HB 1161 Monitor 05-03-16 H Voluntarily Deferred Broadwater, Provides relative to the medical assistance in Committee House

HB 980 Chris(R) program of the state. Health and Welfare Provides relative to the storing and Monitor 05-26-16 G Sent to Moreno, dispensing of naloxone and other opioid the Governor - Act

HB 1007 Helena(D) antagonists. 370 Edmonds, Prohibits abortion based on genetic Monitor 06-06-16 G Sent to

HB 1019 Rick(R) abnormality. the Governor Monitor 04-27-16 H Authorizes the assessment of a provider Voluntarily Deferred Montoucet, fee on Medicaid managed care in Committee House

HB 1029 Jack(D) organizations. Health and Welfare 4- 6-16 H Referred to House Committee on House

HB 1069 Jones, Sam Appropriations 4- 6-16 H Referred to House Committee on House Health and

HB 1070 Jones, Sam Welfare Monitor 04-13-16 H Provides relative to the licensure of Voluntarily Deferred Magee, therapeutic marijuana dispensing in Committee House

HB 1043 Tanner(R) pharmacies. Health and Welfare Monitor 04-27-16 H Voluntarily Deferred Hunter, Provides relative to prescribing of in Committee House

HB 1054 Marcus(D) controlled dangerous substances. Health and Welfare Monitor 04-06-16 H Referred Authorizes the assessment of a provider to House Committee fee on Medicaid managed care on House Health and

HB 1070 Jones, Sam(D) organizations. Welfare

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Monitor 05-02-16 H Removed from hearing Seabaugh, Provides relative to claims against PPOs by 05/03/16 - House

HB 1082 Alan(R) providers. Insurance Monitor 04-27-16 H Voluntarily Deferred Establishes the Louisiana Therapeutic Use in Committee House

HB 1112 James, Ted(D) of Cannabis Act. Health and Welfare Prohibits certain contractual provisions in Monitor Broadwater, provider contracts with health insurance 08-01-16 G Effective -

HB 1140 Chris(R) issuers. Act 265 Requires a child wellness evaluation for Monitor each student entering kindergarten or 5-18-16 S Failed to

HB 1144 Leger, Walt sixth grade. Pass in Committee. Monitor Provides a time frame for appeals of adverse determinations made regarding R.JOHNSON the medical necessity of prescription

HB 1151 drugs and intravenous infusions. 6- 3-16 G Enrolled Stokes, Provides relative to the Medicaid recovery Oppose 6- 2-16 G Sent to the

HB 1157 Julie(R) audit contractor program. Governor Revises fee amounts for facilities and Monitor 5-24-16 H Returned Stokes, providers licensed by the Dept. of Health to the calendar -

HB 1158 Julie(R) and Hospitals. subject to call Monitor 6- 6-16 S Senate Provides relative to functions and adopted the composition of the La. State Board of conference report

HB 1161 Miller, Dustin Nursing. (Vote: Y: 33/N: 4) Monitor Requires the Department of Health and Hospitals to implement the Medicaid 5-18-16 H Failed to health home option for persons with pass (Vote: Y: 33/N:

HB 1164 Norton serious mental illness. 51) Monitor Requests a study of means by which to Willmott, enhance access to health services in 06-06-16 G Filed with

HR 230 Tom(R) health professional shortage areas. the Secretary of State Monitor 04-07-16 H MEDICAID: Increases monthly premiums Voluntarily Deferred charged to families receiving services in Committee House

HCR1 BACALA through the LaCHIP Phase V program Health and Welfare Monitor 05-11-16 H MEDICAID: Amends administrative rules Voluntarily Deferred to provide for a Medicaid expansion cost in Committee House

HCR4 IVEY containment program Health and Welfare

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Monitor Continues the study committee to evaluate the statewide system of Smith, healthcare delivery created by HCR No.

HCR 22 Patricia(D) 170 of the 2015 R.S. 05-13-16 G Enrolled Creates a study group to make Support recommendations concerning the prospective establishment of an Hoffman, independent health professions scope of 05-17-16 S Failed to

HCR 86 Frank(R) practice review committee Pass in Committee. Support 06-06-16 H House concurred in Senate LeBas, Establishes the Commission on Preventing amendments (Vote:

HCR 113 Bernard(D) Opioid Abuse. Y: 98/N: 0) Directs the Louisiana State Board of Monitor Medical Examiners to study and make recommendations concerning a potential tiered approach for placing physicians on probation and a best practice for the Jackson, reporting of the probationary status of a

HCR 134 Katrina(D) physician 06-06-16 G Enrolled

Senate Bills HEALTH CARE: Extends legislative authority for Support

SB21 BOUDREAUX the Louisiana Obesity Prevention and 08-01-16 G Effective - Management Commission. (8/1/16) Act 186 CRIME/PUNISHMENT: Prohibits the harvest, Monitor

SB33 GATTI collection, sale, or transport of organs or body 08-01-16 G Effective - parts of aborted babies. (8/1/16) Act 196 MALPRACTICE: Provides exclusion from Oppose coverage for medical malpractice by doctor 05-17-16 S Returned to SB36 GATTI practicing outside his specialty or hospital the calendar - subject to privileges. (8/1/16) call Oppose 05-04-16 S Voluntarily MEDICAID: Provides with respect to payment Deferred in Committee SB38 GATTI of nonemergency services rendered in an Senate Health and emergency room to certain patients. (8/1/16) Welfare Monitor 02-29-16 S Referred to MEDICAID: Provides for the creation of a single Senate Committee on SB52 MILLS preferred drug list for reimbursement of Senate Health and Medicaid covered outpatient drugs. (gov sig) Welfare

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CONTROL DANGER SUBSTANCE: Provides for Monitor retention, archiving, and destruction of records SB56 JOHNS in the state prescription monitoring program. 08-01-16 G Effective - (8/1/16) Act 189 Oppose 05-18-16 S Returned to MALPRACTICE: Increases medical malpractice SB78 GATTI the calendar - subject to cap for child brain injuries. (gov sig) call PHYSICIANS: Provides for exceptions to Support dispensing limits by prescribers who are 03-01-16 S Referred to SB86 JOHNS practicing at a National Cancer Institute- Senate Committee on designated comprehensive cancer center. (gov Senate Health and sig) Welfare HEALTH/HOSPITALS DEPT: Provides for the re- Monitor creation of the Department of Health and SB107 BARROW Hospitals and to change the name to 06-02-16 G Effective - Department of Health. (See Act) Act 300 HEALTH/HOSPITALS DEPT: Requires approval Monitor by the secretary of the Department of Health and Hospitals for any salary adjustments or SB114 LAFLEUR cost of living adjustments for certain management boards falling under the auspices 06-02-16 G Effective - of the department. (gov sig) Act 338 MEDICAID: Provides for the Medicaid Monitor

SB117 MILLS Pharmaceutical and Therapeutics Committee. 06-02-16 G Effective - (gov sig) Act 339 HEALTH CARE: Creates the Louisiana Family Monitor 03-31-16 S Substituted SB121 COLOMB Caregiver Act. (gov sig) by - see SB 376 HEALTH CARE: Provides for alternative options Oppose 06-06-16 G Sent to the SB131 JOHNS to prescription drugs. (8/1/16) Governor Support 03-02-16 S Referred to HEALTH CARE: Provides for prescription drug Senate Committee on SB133 JOHNS access. (8/1/16) Senate Health and Welfare Monitor HEALTH/ACC INSURANCE: Provides relative to 03-03-16 S Referred to SB181 LONG the Network Adequacy Act. (8/1/16) Senate Committee on Senate Insurance Oppose 05-31-16 H Returned to NURSES: Provides relative to advanced SB187 BARROW the calendar - subject to practice registered nursing. (gov sig) call PHARMACISTS: Provides for pharmacist Monitor 05-26-16 G Effective - SB189 JOHNS dispensing exceptions. (gov sig) Act 192

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HEALTH/ACC INSURANCE: Provides relative to Monitor the adequacy of networks utilized by health 03-29-16 S Removed SB193 LONG insurance issuers for the provision of health from hearing 03/30/16 - care services. (8/1/16) Senate Insurance PUBLIC CONTRACTS: Requires the use of a Monitor standard procurement process for certain solicitations between the state and a nonpublic SB197 GATTI party for hospital services, health care services, 03-03-16 S Referred to or other services in the amount of $1 million or Senate Committee on more. (7/1/16) Senate Finance Oppose 03-03-16 S Referred to NURSES: Provides relative to advanced Senate Committee on SB206 T.CARTER practice registered nursing. (gov sig) Senate Health and Welfare Oppose 03-16-16 S Recommitted CHIROPRACTORS: Provides for the practice of SB208 COLOMB Senate Health and chiropractic. (gov sig) Welfare HEALTH SERVICES: Provides relative to Monitor 06-02-16 G Effective - SB210 BARROW behavioral health services. (gov sig) Act 344 HEALTH SERVICES: Provides relative to the Monitor

SB230 PETERSON Health Education Authority of Louisiana (HEAL). 06-06-16 G Sent to the (8/1/16) Governor CORONERS: Provides relative to admissions by Monitor emergency certificate of persons suffering SB236 BARROW from mental illness and substance abuse. 05-25-16 G Sent to the (8/1/16) Governor - Act 384 ADMINISTRATIVE PROCEDURE: Provides for Monitor proper venue for all administrative hearings SB239 MILKOVICH involving action against regulated professions 04-26-16 S Failed to Pass and occupations. (8/1/16) in Committee FUNDS/FUNDING: Provides for a limitation Monitor 06-01-16 H Returned to

SB253 PEACOCK relative to certain appropriations to the LSU the calendar - subject to Health Sciences Center of Shreveport. (7/1/17) call HEALTH/ACC INSURANCE: Provides for Monitor

SB258 LUNEAU coverage for refills for prescription eye drops. 08-01-16 G Effective - (8/1/16) Act 206 Monitor 03-21-16 S Removed CONTRACTS: Provides for a prohibition on from hearing 03/22/16 - SB264 MILLS expenditure of funds regarding abortions. (gov Senate Health and sig) Welfare PHARMACISTS: Provides for medical Monitor/Oppose 05-19-16 G Effective - SB271 MILLS marijuana. (gov sig) Act 96

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Monitor 03-04-16 S Referred to LSU SYSTEM: Provides relative to the definition Senate Committee on SB282 APPEL of medically indigent. (8/1/16) Senate Health and Welfare HEALTH CARE: Provides for patient access to Oppose physical therapy services without a SB291 MILLS prescription or referral from a physician. (gov 06-02-16 G Sent to the sig) Governor - Act 396 Support 04-13-16 S Voluntarily HEALTH SERVICES: Provides for staffing Deferred in Committee SB300 CLAITOR standards at ambulatory surgical centers. Senate Health and (8/1/16) Welfare HEALTH/ACC INSURANCE: Provides relative to Oppose balance billing by and reimbursement of

SB316 DONAHUE noncontracted facility-based physicians for 04-13-16 S Voluntarily covered health care services rendered in an in- Deferred in Committee network health care facility. (8/1/16) Senate Insurance HOSPITALS: To provide for a funding formula Monitor 04-20-16 S Voluntarily for new hospitals that are in adversely Deferred in Committee SB321 MORRELL impacted areas with limited patient access. Senate Health and (8/1/16) Welfare Oppose 05-17-16 H Returned to HEALTH CARE: Provides for telehealth access. SB328 CLAITOR the calendar - subject to (8/1/16) call GOVERNMENTAL REGULATIONS: Provides Monitor 03-04-16 S Referred to

SB341 MARTINY relative to the Louisiana Massage Therapists Senate Committee on and Massage Establishments Act. (8/1/16) Senate Commerce HEALTH CARE: Provides for the Louisiana Support

SB360 MILLS Physician Orders for Scope of Treatment 06-02-16 G Sent to the (LaPOST) form. (gov sig) Governor MEDICAID: Provides relative to the Medical Monitor 04-28-16 S Substituted

SB362 JOHNS Assistance Program. (8/1/16) by - see SB 473 Colomb, Creates the Louisiana Family Caregiver Act. Monitor 8- 1-16 G Effective - Act

SB 376 Yvonne Became SB 376 351 Provides for the Louisiana State Board of Oppose Medical Examiners, membership, congressional districts, qualifications, and appointment 06-06-16 G Sent to the

SB 429 Barrow(D) process. Governor Monitor Provides for mandatory meetings of the Health and Social Services Estimating Conference for purposes of developing budget 06-06-16 G Sent to the

SB 443 Hewitt(R) recommendations for the Medicaid program. Governor Monitor 05-17-16 S Returned to Provides relative to freestanding emergency the calendar - subject to

SB 465 Barrow(D) medical care facilities. call

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Monitor Provides a procedure for the LSU Board of Supervisors and the commissioner of administration to seek approval from the JLBC and the legislature to proceed with the sale of 06-06-16 G Sent to the

SB 466 Hewitt(R) a hospital. Governor Monitor 6- 2-16 H House appointed a conference Provides relative to the Medical Assistance committee Boradwater, Hoffmann and Cromer SB 473 Johns(R) Program. Monitor HEALTH CARE: Directs the Department of Health and Hospitals to evaluate and report on 04-04-16 G Filed with funding solutions for in-home support the Secretary of State

SR6 BARROW providers. Monitor Requests a study of ways to enhance access to 06-07-16 G Filed with health care services in health professional the Secretary of State

SR 191 Barrow(D) shortage areas. Monitor Requests continuation of the working group to study the impact of nurse practitioners on 06-07-16 G Filed with enhancement of access to health care in the Secretary of State

SR 193 Barrow(D) medically underserved areas. Requests the Louisiana State Board of Nursing Opposed and the Louisiana State Board of Medical 06-06-16 S Returned to Examiners to jointly develop and promulgate the calendar - subject to rules governing exemption from the call collaborative practice agreement between an

SR 196 Barrow(D) advanced practice RN and a physician. HEALTH/HOSPITALS DEPT: Directs the Monitor Department of Health and Hospitals to submit 05-27-16 G Filed with a report by May 1, 2016, and to add the Secretary of State Adrenoleukodystrophy (ALD) to the newborn

SCR3 MILLS screening panel no later than January 1, 2017. Monitor HEALTH SERVICES: Continues the task force to study and make recommendations concerning 05-27-16 G Filed with health services delivery and financing in the the Secretary of State

SCR4 BARROW Baton Rouge region. SPEECH/PATH/AUDIO: Directs the Louisiana Monitor Board of Examiners for Speech-Language 04-20-16 S Voluntarily Pathology and Audiology to evaluate and Deferred in Committee report on licensing requirements and Senate Commerce procedures that may need to be updated in

SCR5 CLAITOR current law.

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HEALTH/HOSPITALS DEPT: Directs the Monitor Department of Health and Hospitals to 04-05-16 H Referred to evaluate and report on the number of Bayou House Committee on Health plans that are necessary and House Health and appropriate before releasing another RFP to Welfare

SCR9 MILLS procure such plans. Monitor VITAL STATISTICS: Directs the Department of Health and Hospitals to evaluate and report on 05-13-16 G Filed with increasing access to vital records at parish the Secretary of State

SCR11 BOUDREAUX health units.

Respectfully submitted, James A Taylor, Jr, MD 2015-2016 Legislative and Membership Issues Committee Chair

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Membership Report James A. Taylor, Jr., MD - Chair

Acknowledgment: The Legislative and Membership Issues Committee has worked tirelessly on your behalf and I would like to acknowledge and thank the members who served:

Chris Achee, MD Eldridge G. Burns, MD James Campbell, MD Lacey Cavanaugh, MD Mark Dawson, MD Phillip Ehlers, MD Chris Foret, MD Indira Gautam, MD Wayne Gravois, MD Alan LeBato, MD Edward Martin, Jr., MD Meredith Maxwell, MD Patrick Moore, MD Joseph Nida, MD Bryan Picou, MD Marguerite “Cissy” Picou, MD M. Tahir Qayyum, MD Nicholas Seelinger, MD Carol Smothers, MD Zeb Stearns, MD

The Committee on Legislative and Membership Issues met twice this year via conference on March 5 and April 11, 2016. The following are the highlights that the Committee worked on this past year:

Membership Recognition The Louisiana Academy won an award for 100 percent resident membership. The award was presented in Kansas City, MO on May 6 during the AAFP Annual Chapter Leaders Forum/National Conference of Constituency Leaders. With the large number of family medicine residencies in Louisiana and the number of potential resident members, to achieve the 100% mark is a tribute to the membership recruitment and retention efforts of Louisiana's family medicine residency program directors, LAFP leadership, and staff.

Membership in the LAFP Enrollment as a member of the LAFP occurs with enrollment in the AAFP, and so much of our membership information is provided by the national organization. As of April 30, our state chapter membership was up by 180 members compared with the same date in 2015.

The LAFP staff monitors membership closely. There were 10 members who had not reported adequate CME credits for their 2015-2016 re-election cycle (compared to 9 in 2015), and 81 who had not paid 2016 dues (compared to 87 in 2015). Those members were dropped from membership by the AAFP on May 4, 2016. As of May 31, 2016, 68 members still remain cancelled.

At the end of the annual AAFP drop date, membership was 1,922, which includes 961 active members, 728 students, 145 residents, 79 Life members, 5 inactive members, and 4 supporting members.

In addition, Inactive members are reviewed annually and placed back into Active status unless they have a hardship or are retired and just have not yet reached Life status by virtue of AAFP membership affiliation years. Possible Life members are sent a notice in advance of the AAFP annual membership dues so that they are aware of their new status change.

Awards This committee continues to affirm the value of recognizing professional achievement among LAFP members as a way to honor

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General Assembly – July 8, 2016 – Destin, FL and reinforce the value of Family Physicians in our state. We are proud of all our members and would encourage our membership to look at the accomplishments of their colleagues and partners with an eye toward increasing our pool of award nominees. For 2016, we are happy to recognize:

Janice Dara LSU-Shreveport Michael O. Fleming, MD Award Danielle Fuselier LSU-New Orleans Gerald R. Gehringer Family Medicine Award Nicole Gentile Tulane Family Medicine Excellence Award Micah Pippin, MD Resident of Excellence Award Bryan Picou, MD LAFP Nominee to AAFP Physician of the Year -

Congratulations to all our 2016 award winners!

Membership Survey The LAFP staff is currently revising our Membership Survey, which will be going out to all LAFP members when it is complete. This survey gathers critical data about our members, which is then used to inform our representatives in the Capitol as well as providing insight into the composition of family medicine in Louisiana. When this survey comes out, we would like to encourage all members to complete it so that we have more accurate data to work with.

General Chapter Overview: The Louisiana AFP is a medium chapter (401 to 1,000 active members) with the following membership numbers:

April 2015 April 2016 Active 944 Active 961 Honorary 0 Honorary 0 Inactive 6 Inactive 5 Supporting (FP) 2 Supporting (FP) 3 Supporting (non-FP) 0 Supporting (non- 1 Life 73 FP) Life 79 Resident 143 Resident 145 Student 574 Student 728 TOTAL 1,742 TOTAL 1,922

LA AFP’s active membership is up 17 members between April 2015 and April 2016—a 1.80% increase. AAFP saw a 1.30% increase in active membership during this same time period.

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Active Membership: AAFP’s Active membership has grown steadily over the past 10 years (15.84%), including a 6.52% growth in the last five years. AAFP saw a 1.30% increase in the last year (end of the year 2014 to end of the year 2015).

The LA AFP has experienced a 23.34% growth rate of active members in the same 10-year period, and a 5.68% rate in the last 5 years. After a dip in this area in 2012, the chapter has seen a 4.69% growth rate since 2013 and a 1.36% growth rate from end of year 2014 to the end of year 2015. The chapter currently has the most of active members they have ever had.

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Active Membership (compared to four similar-sized chapters):

Three of the five chapters compared above saw an increase or maintained their active member growth rate at the 10, 5, 3 and 1-year comparison points. The LA AFP saw the second highest growth rate at the 5 and 3- year comparison points of the chapters compared above and the third highest growth rate the past year.

Active Member Retention: The AAFP rate of Active member retention saw a two-year decline from 2007 through 2009 of 2.1%. After an increase of 1.6% increase from 2009 to 2011, the AAFP has decreased 0.9% to 94.2%.

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The LA AFP rate of active member retention saw a decrease of 0.2% from 2007 to 2009, and an increase of 0.8% from 2009 to 2011. The chapter does not follow AAFP trends, as they maintained their retention rate since 2013, whereas AAFP saw a 0.7% decrease in that same time period.

Active Member Retention (compared to four similar-sized chapters):

Three of the chapters compared above experienced a decrease in retention rates from 2011 to 2015 (Only OK and AL saw an increase). Two of these chapters also experienced a decrease in active member retention rates from end of year 2014 to end of year 2015. Of the three chapters showing an increase from 2014 to 2015, LA saw the 3rd highest growth rate of 0.2%.

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Student Membership: AAFP student membership experienced a decreased of 10.14% from 2005 to 2010. That trend has since shifted showing a 51.31% increase the past 5 years and a 17.74% growth since 2013. Over the last year, the AAFP has seen a 5.33% student member increase.

Student membership in the LA AFP increased by 12.11% from 2005 to 2010, whereas, the AAFP experienced a decrease of 10.14% during the same period. The chapter has since seen a 39.52% increase in student membership from 2011 to 2015, with a 16.03% increase from end of year 2014 to end of year 2015.Student Membership (compared to four similar-sized chapters):

All but one chapter compared above saw increases in student growth at the 10, 5, 3 and 1-year comparison 6 89

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points. The LA AFP has seen the 3rd highest student growth rate at the 3-year comparison point, and the second highest growth rate at the 1-year comparison point of the chapters compared above.

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Resident Membership: AAFP has seen increases in resident membership at the 10, 5, 3 and 1-year comparison points. From 2006 to 2015 there was a 21.48% increase, 2011 – 2015 a 10.98% and from 2013-2015 a 4.56% increase. AAFP saw a

2.65% increase over the last year.

The LA AFP saw increases in resident membership at the 10, 3, and 1-year comparison points, with a 38.71% growth rate the last 10 years. The chapter also saw a 3.86% increase this past year. Resident Membership (compared to four similar-sized chapters):

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Three of the five chapters compared above saw increases in resident membership at all comparison points. The LA AFP saw the saw the third highest growth rate of those chapters compared above from end of year 2014 to end of year 2015.

First Year Conversion of Family Medicine Residents: (Residents by Chapter – Resident to Active Membership)

Conversion data is not analyzed until 18 months after graduation. Class of 2014 (As of December 31, 2015)

AAFP 76.0% Alabama 88.1% Louisiana 82.6% Arkansas 81.8% Oklahoma 79.2% Kentucky 79.2%

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AAFP and Chapter Data Summaries

Green Headings – Area of Membership is strong and growing Yellow Headings – Area of Membership should be watched closely Red Headings – Area of Membership needs immediate attention

Active Membership (Ranked in Chapter order over the past year based on end of year data)

Ten Year (2006 Five Year (2011 Three Year Past Year (2014 to 2015) to 2015) (2013 to 2015) to 2015) AAFP + 15.84% +6.52% +2.72% +1.30% Alabama +14.59% +10.06% +5.63% +3.61% Oklahoma +12.55% +4.03% +1.19% +1.55% Louisiana +23.34 +5.68% +4.69% +1.36% Arkansas +3.65% +3.78% +0.59% -0.23% Kentucky +7.01% +3.14% -0.35% -1.27%

As of April 30, the LA AFP has 961 Active members—which is a 1.80% increase over the April 2015 figure (up 17 members).

Active Member Retention Rates (Ranked in Chapter order over the past year based on end of year data) Average active membership retention percentages over given time periods.

Ten Year (2006 Five Year (2011 Three Year Past Year (2014 to 2015) to 2015) (2013 to 2015) to 2015) AAFP 94.75% 94.72% 94.50% 94.30% Alabama 94.66% 94.98% 95.30% 95.55% Arkansas 94.30% 94.44% 94.27% 94.60% Louisiana 94.22% 93.94% 94.03% 94.00% Oklahoma 94.41% 93.82% 93.67% 93.70% Kentucky 94.05% 94.38% 93.70% 93.55%

The LA AFP reached an all-time high of 95.9% retention rate in 2010, and a low of 93.5% in 2001. The chapter currently stands at a 94.1% at the end of 2015. The chapter is ranked 6th out of the 15 medium-sized chapters in active member retention rates at the end of 2015.

Member Market Share

2014 2015 AAFP 76.3% 76.5% Arkansas 77.3% 76.4% Alabama 74.7% 76.3% Oklahoma 75.2% 75.8% Louisiana 76.1% 75.0% 1 93 0

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Kentucky 71.4% 71.6%

Three of the five chapters compared above increased their market share from 2014 to 2015.

First-Year New Physicians The LA AFP does participate in the discounted dues program. The average payment rate for those chapters that offered a discount for 2015 dues was 74.47% and those who did not was 71.97%.

Percentage of first-year new physicians who Offered a Dues Discount? paid dues under the 2015 discounted dues AAFP program. 73.95% Yes Arkansas 82.61% Yes Alabama 79.55% Yes Louisiana 76.81% Yes Oklahoma 73.47% Yes Kentucky 70.21% No

Because of the continuing focus on this membership segment – it is important to keep a close eye on new physician members. The lowest percentage for those offering a reduction was 54.55% and the lowest for a chapter who does not offer a discount was 58.16%. Of the 42 chapters who offer discounted dues, 35 of them were over 70% on payment rates. The LA AFP had an 80.39% payment rate at the end of 2014.

Student Membership (Ranked in Chapter order over the past year based on end of year data)

Ten Year (2006 Five Year (2011 Three Year Past Year (2014 to 2015) to 2015) (2013 to 2015) to 2015) AAFP +75.35% +51.31% +17.74% +5.33% Oklahoma +18.42% +315.3% +196.7% +109.3% Louisiana +66.86% +39.52% +32.80% +16.03% Arkansas +190.0% +68.93% +58.18% +16.0% Alabama +126.5% +46.13% +26.54% +4.86% Kentucky +32.54% +119.6% +6.16% -2.18%

At the end of April, the LA AFP had 728 students compared to 574 at the end of April 2015—a 26.83% increase. This is the highest student membership the chapter has ever seen.

Resident Membership (Ranked in Chapter order over the past year based on end of year data)

Ten Year (2006 Five Year (2011 Three Year Past Year (2014 to 2015) to 2015) (2013 to 2015) to 2015) AAFP +21.48% +10.98% +4.56% +2.65% Oklahoma +6.83% -2.82% +11.69% +17.01% Kentucky +28.0% +15.32% +7.56% +4.92% Louisiana +38.71% +12.57% +5.91% +3.86% Arizona +12.08% +16.78% +5.03% +1.83%

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Arkansas +5.44% -4.32% -11.43% -7.19%

Currently, the LA chapter has 145 residents at the end of April compared to 143 at the end of April 2015, a 1.40% increase. The chapter also received the 100% resident membership recognition the last several years.

Respectfully submitted, James A. Taylor, Jr., MD, FAAFP 2015-2016 Legislative and Membership Issues Committee Chair

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Committee on Operations Bryan Picou, MD

(1) The Board periodically reviews finances of all LAFP accounts.

Finances (2) The Board reviewed the Treasurer’s report at all meetings. Our formal financial statement consists of a balance sheet which compares assets and liabilities, a profit & loss statement which illustrates our operational status for the current fiscal year, accounts payable and accounts receivable. This statement included the operating accounts, money market accounts, Foundation accounts, and the PAC account.

(3) Operations For The Year Ended December 31, 2015. All financials can be referenced on pages 99-109 of the General Assembly Handbook.

Calendar Year 2015 (4) The LAFP ended 2015 with a deficit of $ 25,752. Internal operating results for the fiscal year ended December 31, 2015, are as follows:

Actual Budget Difference Operational Revenues 479,714.28 484,820.00 -5,105.72 Operational Expenses 505,466.42 477,196.50 28,269.92 Operational Net Income/(Loss) -25,752.14 7,623.50 -33,375.64

(5) Actual reserves as of December 31, 2015, were computed at $212,895.

Major Variances — Actual Compared To Budget For The Year Ended December 31, 2015 (6) Operational revenue variances were as follows:

Operational Revenues Actual Budget Difference DOT Training Income 7,500.00 25,000.00 -17,500.00 CME Review Fees 14,362.50 8,000.00 6,362.50 Website Advertising/Classified 12,002.88 6,500.00 5,502.88 Membership Dues 227,057.50 239,660.00 -12,602.50 Assembly Revenue 203,388.40 191,910.00 11,478.40

(7) Operational expense variances were as follows:

Operational Expenses Actual Budget Difference DOT Training Expenses 3,096.60 8,077.00 -4,980.40 Administration 243,262.84 238,787.54 4,475.30 Assembly Expenses 120,456.00 100,000.00 20,456.00 Travel 26,421.22 19,819.96 6,601.26 Board and Committees 21,078.36 26,750.00 -5,671.64

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Honoraria And Member Reimbursement (8) Under the Academy's bylaws, the Committee on Operations determines member reimbursement and honoraria for those serving on behalf of the Academy. As part of its annual review of the budget and the Academy's financial policies, the committee reviews each of the various member reimbursement policies established for directors and committee members, and honoraria established for any officers. Financial Policies (9) Financial Reserve Policy – Established in March 2006. This policy establishes appropriate reserves for the Academy to manage its affairs in the event of unforeseen adverse financial situations and provide funds to support one time investments that advance the LAFP’s goals.

(10) The procedure used to calculate the reserve amount for the LAFP is as follows: 1. At the end of each financial year the board will use any excess funds to assure that the reserve fund is minimally at 50% of the Academy’s fixed expenses. 2. If the reserve has reached the 50% threshold, the Board may then use whatever excess funds are available to place in the reserve account. The Board must allocate a minimum of 10% of the excess funds to the Reserve Fund. 3. The Reserve Fund maximum will be set at 100% of the fixed annual expenses. 4. The Treasurer will invest the reserve fund into the vehicles that provide maximum return and minimal risk in the following ratio. a. 25% in a vehicle with a three month liquidity b. 50% in a vehicle with a 9 - 12 month liquidity c. 25% in a vehicle with a 12 - 24 month liquidity 5. Once the reserve fund reaches 100% of the fixed annual expenses, any further funds that would have been deposited into that account will be used to reduce the costs of an academy activity for each active dues paying member.

Other Committee Action (11) The Board agreed to maintain Duplantier, Hrapmann, Hogan & Maher, LLP as the Academy’s auditors for FY 2015 and FY 2016.

Calendar Year 2016 (12) The Board reviewed the 2016 budget proposal and was approved.

(13) After the first half of the current fiscal year no significant problems have been identified at this time. However, a couple of items need to be mentioned. • Membership dues are on target for 2016. • A key driver of profitability is the Annual Scientific Assembly which is budgeted for a profit of $79,750.

Cash on Hand as of 7/01/2016 (14) As of 7/01/2016 the Academy had $370,188.99 cash on hand. Therefore the Academy is currently in sound financial shape.

LAFP Foundation (15) The Foundation had $83,845.50 on hand as of 7/01/2016.

97 Operations Committee Report, continued

General Assembly – July 8, 2016 – Destin, FL

LaFamPac (16) LaFamPac had $4,965.97 on hand as of 7/01/2016.

Bylaws (17) The Committee reviewed the LAFP Constitution & Bylaws and submitted resolutions to the 2015 LAFP General Assembly to make changes in order to be in compliance with recent AAFP Bylaws changes. The Committee also reviewed the Policy Manual and those changes were made.

(18) It has been a privilege being the Chairman of the Operations Committee for the past year and I wish to offer my gratitude to all members of the Committee, especially Ragan LeBlanc for agenda and minutes preparation as well as preparation of the financial reports. I would also like to thank those who serve on the committee:

James Taylor, Jr., MD (Pres Elect) Chris Foret, MD (Secretary) Derek Anderson, MD (Spkr.) Daniel Jens, MD (Vice-Spkr.) Melvin Bourgeois, MD (Immed Past Pres)

Summary (19) Overall, the Academy is financially stable with an adequate cushion of capital to cover expenses for the next 12 months. The LAFP is financially stable and no significant financial problems are anticipated in the near future. The Executive Vice President and the Board of Directors will continue to monitor expenses in order to maintain the good financial position of the Academy.

Respectfully Submitted, Bryan Picou, MD Treasurer

98 Operations Committee Report, continued

General Assembly – July 8, 2016 – Destin, FL

2015 Financials – January through December

Jan - Dec $ Over 15 Budget Budget

Ordinary Income/Expense

Income

800-000 · DOT Training

800-001 · Registrations 7,500.00 25,000.00 -17,500.00

Total 800-000 · DOT Training 7,500.00 25,000.00 -17,500.00

609-000 · Legislative Sponsorship/Grant 9,275.00 7,500.00 1,775.00

626-000 · Leadership Road Show 0.00 2,500.00 -2,500.00

625-000 · White Coat Day Sponsor 2,500.00 2,500.00 0.00

613-000 · Website Advertising/Classified 12,002.88 6,500.00 5,502.88

615-000 · CME Review Fees Reim. 14,362.50 8,000.00 6,362.50

621-000 · Admin. Mtg. Reim. 0.00 0.00 0.00

617-000 · Staff Travel Reim. 1,178.30 0.00 1,178.30

605-000 · Foundation Donations made by CC 0.00 0.00 0.00

105-700 · LaFamPac Donations 0.00 0.00 0.00

602-000 · Membership Dues Income

602-700 · First Year New Physicians 0.00 7,480.00 -7,480.00

602-600 · Life Dues 275.00 0.00 275.00

602-500 · Inactive Dues 962.50 0.00 962.50

602-100 · Active Dues 221,875.00 228,525.00 -6,650.00

602-150 · Dues Supporting 825.00 550.00 275.00

602-400 · Dues Resident 3,120.00 3,105.00 15.00

Total 602-000 · Membership Dues Income 227,057.50 239,660.00 -12,602.50

603-000 · Partnership Rebates

603-900 · Job Target 805.10 0.00 805.10

603-200 Atlantic Health Partner 855.00 750.00 105.00

603-300 · Core Content Review 523.40 500.00 23.40

Total 603-000 · Partnership Rebates 2,183.50 1,250.00 933.50

604-000 · Annual Assembly Revenues

604-101 · Guest Registrations 2,625.00 2,250.00 375.00

604-401 · Sponsorship 39,500.00 36,500.00 3,000.00

604-502 · Golf Tournament Registration 1,350.00 0.00 1,350.00

604-501 · Auction Income 9,698.00 0.00 9,698.00

604-100 · Registrations 44,375.00 47,500.00 -3,125.00

604-200 · Educational Grants 15,500.00 16,500.00 -1,000.00

604-300 · Exhibit Income 79,100.00 70,000.00 9,100.00

604-400 · Advertising 4,550.00 5,000.00 -450.00

604-500 · Foundation Donation

99 Operations Committee Report, continued

General Assembly – July 8, 2016 – Destin, FL

604-507 · Tulane Fund Donation 0.00 0.00 0.00

604-506 · Tar Wars Donation 350.00 0.00 350.00

604-505 · Jean Aitken Fund 0.00 0.00 0.00

604-504 · General Donation 325.00 0.00 325.00

604-503 Gehringer Fund Donation 0.00 0.00 0.00

604-508 · F.P. Bordelon Fund 300.00 0.00 300.00

604-509 · Fleming Fund Donation 50.00 0.00 50.00

Total 604-500 · Foundation Donation 1,025.00 0.00 1,025.00

604-700 · Extra Ticket Sales 3,025.00 2,000.00 1,025.00

604-800 · Assembly Student Fund 0.00 9,500.00 -9,500.00

604-900 · Rooming Commission 2,640.40 2,660.00 -19.60

Total 604-000 · Annual Assembly Revenues 203,388.40 191,910.00 11,478.40

608-000 · Interest Income 16.20 0.00 16.20

618-000 · Student Fund Donations 250.00 0.00 250.00

Total Income 479,714.28 484,820.00 -5,105.72

Expense

851-001 · Income Taxes 0.00 0.00 0.00

801-000 · DOT Training Expenses

801-002 · Speaker Honorarium 2,500.00 2,500.00 0.00

801-012 · CME Review Fee 0.00 177.00 -177.00

801-011 · Lunch 392.49 1,000.00 -607.51

801-010 · Breaks 0.00 0.00 0.00

801-009 · Breakfast 0.00 2,000.00 -2,000.00

801-008 · Supplies 30.89 300.00 -269.11

801-007 · Registration Materials 0.00 300.00 -300.00

801-006 · Signs 0.00 300.00 -300.00

801-005 · A/V 0.00 0.00 0.00

801-004 · Room Rental 0.00 0.00 0.00

801-003 · Speaker Expenses 0.00 500.00 -500.00

801-001 · Materials 173.22 1,000.00 -826.78

Total 801-000 · DOT Training Expenses 3,096.60 8,077.00 -4,980.40

894-000 · Partnership Expenses 0.00 0.00 0.00

911-000 · LAFP Reserve Account 0.00 0.00 0.00

6999 · Uncategorized Expenses 15.16 0.00 15.16

919-000 · Payroll Expenses

919-400 · Employee Retirement 3,534.20 3,534.20 0.00

919-300 · Staff Health Benefits 12,671.45 15,860.00 -3,188.55

919-001 · Payroll Processing Fees 1,395.68 1,344.00 51.68

919-004 · Payroll Taxes

404-000 · Social Security Expense 14,792.00 11,500.00 3,292.00

407-000 · Futa Payable 201.00 175.00 26.00

408-000 · Suta Payable 686.06 750.00 -63.94 100 Operations Committee Report, continued

General Assembly – July 8, 2016 – Destin, FL

919-004 · Payroll Taxes - Other -1.07

Total 919-004 · Payroll Taxes 15,677.99 12,425.00 3,252.99

919-002 · Payroll Wages

919-110 · Staff Salaries 177,483.56 173,124.38 4,359.18

919-200 · Contract Labor 32,499.96 32,499.96 0.00

Total 919-002 · Payroll Wages 209,983.52 205,624.34 4,359.18

Total 919-000 · Payroll Expenses 243,262.84 238,787.54 4,475.30

923-000 Donation to Foundation 2,188.04 3,000.00 -811.96

851-000 · Accounting 396.84 300.00 96.84

852-000 · Audit Fee 6,700.00 6,500.00 200.00

854-000 · Advertising/Classified 0.00 300.00 -300.00

860-000 · Bank Charges 11,013.50 10,000.00 1,013.50

875-000 · Assembly Expenses

875-650 · Welcome Reception 14,165.18 10,000.00 4,165.18

875-900 · Foundation Activities

875-903 · Auction 2,179.37 0.00 2,179.37

875-901 · Golf Tournament 4,546.26 0.00 4,546.26

Total 875-900 · Foundation Activities 6,725.63 0.00 6,725.63

875-100 · Postage and Handling 2,221.05 1,000.00 1,221.05

875-200 · Printing & Typesetting 4,999.32 7,000.00 -2,000.68

875-400 · Travel 6,728.70 3,000.00 3,728.70

875-405 · Student Sponsorship 0.00 0.00 0.00

875-505 · Projectionist/AV 10,689.20 8,000.00 2,689.20

875-510 · Speaker Expenses 1,775.56 3,000.00 -1,224.44

875-513 · Speaker Honorarium 2,500.00 3,000.00 -500.00

875-515 · Sign & Posters 1,950.39 750.00 1,200.39

875-525 · Decorations 324.83 500.00 -175.17

875-540 · Photos/Photographer 1,350.00 1,200.00 150.00

875-550 · Badges & Registration Supplies 651.37 500.00 151.37

875-555 · Gifts 1,497.23 400.00 1,097.23

875-560 · Prizes (Registrants) 54.45 200.00 -145.55

875-565 · Plaques & Pins 983.29 500.00 483.29

875-570 · Member Appreciation Gifts 197.44 500.00 -302.56

875-575 · Nat'l Rep Entertainment 1,860.36 2,000.00 -139.64

875-600 · Meals/Breakfast 15,788.65 19,500.00 -3,711.35

875-605 · Meals/Lunch 21,246.88 18,800.00 2,446.88

875-610 · Meals/Breaks 2,947.11 6,500.00 -3,552.89

875-625 · President's Party 21,017.65 13,000.00 8,017.65

875-630 · Outside Social Functions 0.00 0.00 0.00

875-700 · Insurance 781.71 650.00 131.71

875-750 · Security 0.00 0.00 0.00

Total 875-000 · Assembly Expenses 120,456.00 100,000.00 20,456.00 101 Operations Committee Report, continued

General Assembly – July 8, 2016 – Destin, FL

880-000 · Subscriptions 470.79 150.00 320.79

881-000 · Dues (ASAE, LSAE, PCMA, etc) 424.00 595.00 -171.00

893-000 · Magazine Expense 2,995.68 4,000.00 -1,004.32

898-000 · Flowers, Gifts & Memorials 992.92 650.00 342.92

899-000 · Staff Educational Benefits 105.80 1,000.00 -894.20

900-000 · Travel

900-700 · AAFP NCSC 3,052.52 1,860.00 1,192.52

900-600 · AAFP Annual Leadership Forum 5,058.17 3,009.96 2,048.21

900-500 · AAFP Congress of Delegates 10,840.86 10,000.00 840.86

900-400 · Southeastern Forum travel 3,869.88 3,950.00 -80.12

900-300 · Staff Travel 3,599.79 1,000.00 2,599.79

Total 900-000 · Travel 26,421.22 19,819.96 6,601.26

904-000 · Insurance

904-100 · Property & Liability Insurance 5,239.41 5,000.00 239.41

904-150 · Flood Insurance 1,882.00 1,650.00 232.00

904-200 · Insurance-Officers, Directors 1,490.00 1,480.00 10.00

904-300 · Insurance Workers Comp 800.00 1,000.00 -200.00

Total 904-000 · Insurance 9,411.41 9,130.00 281.41

914-000 · Legal 0.00 0.00 0.00

917-000 · Printing

917-400 · Printing - LaFamPac 0.00 400.00 -400.00

917-500 · Printing - Membership 0.00 1,000.00 -1,000.00

917-100 · General Printing 1,643.03 1,000.00 643.03

Total 917-000 · Printing 1,643.03 2,400.00 -756.97

918-000 · Office Supplies 6,048.43 5,000.00 1,048.43

924-000 · Postage & Mail Handling

924-300 · General Postage 298.74 1,500.00 -1,201.26

924-100 · Postage Meter Rental 1,366.58 1,400.00 -33.42

Total 924-000 · Postage & Mail Handling 1,665.32 2,900.00 -1,234.68

926-000 · President's Expenses 1,856.01 3,500.00 -1,643.99

928-000 · Pest Control Services 575.00 500.00 75.00

930-000 · Building-Repairs & Maint. 2,612.38 1,000.00 1,612.38

931-000 · Equipment-Repairs & Maint. 2,405.84 500.00 1,905.84

932-000 · Office Equip. Maint.-Contracts 6,435.44 6,262.00 173.44

933-000 · Ofc/Yd Cleaning & Supplies 3,993.76 3,540.00 453.76

934-000 · Web-Site Maint. 7,961.84 5,380.00 2,581.84

941-000 · Telephone 11,829.78 10,155.00 1,674.78

945-000 · Utilities

945-100 · Electricity (Entergy) 3,363.97 2,500.00 863.97

945-200 · Water 343.16 275.00 68.16

Total 945-000 · Utilities 3,707.13 2,775.00 932.13

949-000 · Office Equip. (Comp./Upgrade) 1,208.86 500.00 708.86 102 Operations Committee Report, continued

General Assembly – July 8, 2016 – Destin, FL

950-000 · Administrative Meetings 1,164.18 1,000.00 164.18

951-000 · Committees

951-600 · RSLCommittee 0.00 100.00 -100.00

951-500 · Board/Committee Mtgs. 1,374.26 1,000.00 374.26

951-100 · Education Committee 1,956.00 1,625.00 331.00

951-250 · Legislative & Membership

951-350 · Giveaways/Promotional Items 7,769.43 5,000.00 2,769.43

951-320 · Legislative District Breakfast 1,582.16 3,000.00 -1,417.84

951-310 · First Aid Station 5,929.34 7,000.00 -1,070.66

951-290 · Legislative & Advocacy Seminar 765.50 2,000.00 -1,234.50

951-280 · White Coat Day at the Capital 2,358.42 3,000.00 -641.58

951-270 · FM Congressional Conference 0.00 0.00 0.00

951-260 · State Legislative Conference 2,397.60 2,750.00 -352.40

951-250 · Legislative & Membership - Other 275.91 4,000.00 -3,724.09

Total 951-250 · Legislative & Membership 21,078.36 26,750.00 -5,671.64

951-400 · Operations Committee 0.00 0.00 0.00

Total 951-000 · Committees 24,408.62 29,475.00 -5,066.38

Total Expense 505,466.42 477,196.50 28,269.92

Net Ordinary Income -25,752.14 7,623.50 -33,375.64 Net Income -25,752.14 7,623.50 -33,375.64

103 Operations Committee Report, continued

General Assembly – July 8, 2016 – Destin, FL

Current Financials – January, 2016 through July 1, 2016

Jan - Dec $ Over 16 Budget Budget

Ordinary Income/Expense Income 611-000 · FMPC Grant - LAFP 101 5,000.00 0.00 5,000.00 800-000 · DOT Training

800-001 · Registrations 0.00 0.00 0.00 Total 800-000 · DOT Training 0.00 0.00 0.00 609-000 · Legislative Sponsorship/Grant 5,000.00 5,000.00 0.00 625-000 · White Coat Day Sponsor 5,000.00 2,500.00 2,500.00 613-000 · Website Advertising/Classified 2,945.53 27,410.00 -24,464.47 615-000 · CME Review Fees Reim. 10,112.50 13,112.50 -3,000.00 617-000 · Staff Travel Reim. 1,753.59 0.00 1,753.59 605-000 · Foundation Donations made by CC 100.00 0.00 100.00 105-700 · LaFamPac Donations 1,602.00 0.00 1,602.00 700-000 · 2004 SE Forum Income 700-300 · SE Forum Misc. Income 7,750.00 0.00 7,750.00 700-200 · SE Forum Grants 15,000.00 0.00 15,000.00

700-100 · SE Forum Registrations 201.60 0.00 201.60 Total 700-000 · 2004 SE Forum Income 22,951.60 0.00 22,951.60 602-000 · Membership Dues Income 602-700 · First Year New Physicians 0.00 9,150.00 -9,150.00 602-600 · Life Dues 1,624.91 300.00 1,324.91 602-500 · Inactive Dues 900.00 1,200.00 -300.00 602-100 · Active Dues 225,473.87 245,100.00 -19,626.13 602-150 · Dues Supporting 900.00 900.00 0.00

602-400 · Dues Resident 3,195.00 3,165.00 30.00 Total 602-000 · Membership Dues Income 232,093.78 259,815.00 -27,721.22 603-000 · Partnership Rebates 603-900 · Job Target 829.88 500.00 329.88 603-200 Atlantic Health Partner 100.00 750.00 -650.00

603-300 · Core Content Review 0.00 500.00 -500.00 Total 603-000 · Partnership Rebates 929.88 1,750.00 -820.12 604-000 · Annual Assembly Revenues 604-101 · Guest Registrations 1,575.00 1,125.00 450.00 604-401 · Sponsorship 27,250.00 28,000.00 -750.00 604-502 · Golf Tournament Registration 1,485.00 0.00 1,485.00 604-501 · Auction Income 0.00 0.00 0.00 604-100 · Registrations 28,550.00 51,000.00 -22,450.00 604-200 · Educational Grants 8,500.00 17,000.00 -8,500.00 104 Operations Committee Report, continued

General Assembly – July 8, 2016 – Destin, FL

604-300 · Exhibit Income 51,800.00 76,500.00 -24,700.00 604-400 · Advertising 2,450.00 6,200.00 -3,750.00 604-500 · Foundation Donation 604-511 · Resident Award of Excellence 25.00 0.00 25.00 604-510 · Raffle Tickets 800.00 0.00 800.00 604-507 · Tulane Fund Donation 0.00 0.00 0.00 604-506 · Tar Wars Donation 75.00 0.00 75.00 604-505 · Jean Aitken Fund 0.00 0.00 0.00 604-504 · General Donation 150.00 0.00 150.00 604-503 Gehringer Fund Donation 0.00 0.00 0.00 604-508 · F.P. Bordelon Fund 75.00 0.00 75.00

604-509 · Fleming Fund Donation 0.00 0.00 0.00 Total 604-500 · Foundation Donation 1,125.00 0.00 1,125.00 604-700 · Extra Ticket Sales 175.00 1,500.00 -1,325.00 604-800 · Assembly Student Fund 75.00 0.00 75.00

604-900 · Rooming Commission 0.00 0.00 0.00 Total 604-000 · Annual Assembly Revenues 122,985.00 181,325.00 -58,340.00

608-000 · Interest Income 2.47 0.00 2.47 Total Income 410,476.35 490,912.50 -80,436.15 Expense 851-001 · Income Taxes 0.00 0.00 0.00 801-000 · DOT Training Expenses 801-002 · Speaker Honorarium 0.00 0.00 0.00 801-012 · CME Review Fee 0.00 0.00 0.00 801-011 · Lunch 0.00 0.00 0.00 801-010 · Breaks 0.00 0.00 0.00 801-009 · Breakfast 0.00 0.00 0.00 801-008 · Supplies 0.00 0.00 0.00 801-007 · Registration Materials 0.00 0.00 0.00 801-006 · Signs 0.00 0.00 0.00 801-005 · A/V 0.00 0.00 0.00 801-004 · Room Rental 0.00 0.00 0.00 801-003 · Speaker Expenses 0.00 0.00 0.00

801-001 · Materials 0.00 0.00 0.00 Total 801-000 · DOT Training Expenses 0.00 0.00 0.00 894-000 · Partnership Expenses 0.00 0.00 0.00 911-000 · LAFP Reserve Account 0.00 6,000.00 -6,000.00 750-000 · SE Forum Expenses 750-500 · LAFP Staff Time 0.00 0.00 0.00 750-400 · SE Forum Reception 1,576.70 0.00 1,576.70 750-300 · SE Forum Printing/Copies 0.00 0.00 0.00 750-100 · Registration Expenses 0.00 0.00 0.00 105 Operations Committee Report, continued

General Assembly – July 8, 2016 – Destin, FL

750-200 · Hotel Expenses 0.00 0.00 0.00

Total 750-000 · SE Forum Expenses 1,576.70 0.00 1,576.70

919-000 · Payroll Expenses

919-400 · Employee Retirement 3,720.22 3,720.22 0.00

919-300 · Staff Health Benefits 6,077.57 12,671.22 -6,593.65

919-001 · Payroll Processing Fees 587.74 1,440.00 -852.26

919-004 · Payroll Taxes

404-000 · Social Security Expense 4,867.83 11,500.00 -6,632.17

407-000 · Futa Payable 143.10 200.00 -56.90

408-000 · Suta Payable 351.00 750.00 -399.00

919-004 · Payroll Taxes - Other 1.21

Total 919-004 · Payroll Taxes 5,363.14 12,450.00 -7,086.86

919-002 · Payroll Wages

919-110 · Staff Salaries 63,631.58 191,218.60 -127,587.02

919-200 · Contract Labor 22,874.96 35,750.00 -12,875.04

Total 919-002 · Payroll Wages 86,506.54 226,968.60 -140,462.06

Total 919-000 · Payroll Expenses 102,255.21 257,250.04 -154,994.83

923-000 Donation to Foundation 2,508.64 3,000.00 -491.36

851-000 · Accounting 55.00 300.00 -245.00

852-000 · Audit Fee 0.00 6,500.00 -6,500.00

854-000 · Advertising/Classified 0.00 300.00 -300.00

860-000 · Bank Charges 6,924.77 10,000.00 -3,075.23

875-000 · Assembly Expenses

875-506 · Meeting App 4,000.00 4,000.00 0.00

875-650 · Welcome Reception 425.30 15,000.00 -14,574.70

875-900 · Foundation Activities

875-903 · Auction 1,056.13 0.00 1,056.13

875-901 · Golf Tournament 0.00 0.00 0.00

875-900 · Foundation Activities - Other 750.41

Total 875-900 · Foundation Activities 1,806.54 0.00 1,806.54

875-100 · Postage and Handling 0.00 1,000.00 -1,000.00

875-200 · Printing & Typesetting 5,383.03 7,000.00 -1,616.97

875-400 · Travel 0.00 7,000.00 -7,000.00

875-405 · Student Sponsorship 0.00 0.00 0.00

875-505 · Projectionist/AV 0.00 12,000.00 -12,000.00

875-510 · Speaker Expenses 0.00 3,000.00 -3,000.00

875-513 · Speaker Honorarium 0.00 3,000.00 -3,000.00

875-515 · Sign & Posters 0.00 800.00 -800.00

875-525 · Decorations 0.00 500.00 -500.00

875-540 · Photos/Photographer 0.00 1,500.00 -1,500.00

875-545 · Transportation 0.00 0.00 0.00

875-550 · Badges & Registration Supplies 374.95 1,475.00 -1,100.05 106 Operations Committee Report, continued

General Assembly – July 8, 2016 – Destin, FL

875-555 · Gifts 0.00 500.00 -500.00

875-560 · Prizes (Registrants) 0.00 200.00 -200.00

875-565 · Plaques & Pins 824.69 500.00 324.69

875-570 · Member Appreciation Gifts 0.00 500.00 -500.00

875-575 · Nat'l Rep Entertainment 0.00 2,000.00 -2,000.00

875-600 · Meals/Breakfast 2,000.00 10,000.00 -8,000.00

875-605 · Meals/Lunch 0.00 11,000.00 -11,000.00

875-610 · Meals/Breaks 0.00 2,800.00 -2,800.00

875-625 · President's Party 273.00 17,000.00 -16,727.00

875-630 · Outside Social Functions 0.00 0.00 0.00

875-700 · Insurance 656.86 800.00 -143.14

875-750 · Security 0.00 0.00 0.00

Total 875-000 · Assembly Expenses 15,744.37 101,575.00 -85,830.63

880-000 · Subscriptions 304.47 150.00 154.47

881-000 · Dues (ASAE, LSAE, PCMA, etc) 500.00 650.00 -150.00

893-000 · Magazine Expense 1,532.08 3,000.00 -1,467.92

898-000 · Flowers, Gifts & Memorials 0.00 500.00 -500.00

899-000 · Staff Educational Benefits 0.00 1,000.00 -1,000.00

900-000 · Travel

900-800 · CEAC Meeting 0.00 0.00 0.00

900-700 · AAFP NCSC 4,785.07 2,750.00 2,035.07

900-600 · AAFP Annual Leadership Forum 5,173.78 5,180.00 -6.22

900-500 · AAFP Congress of Delegates 0.00 10,000.00 -10,000.00

900-400 · Southeastern Forum travel 0.00 4,950.00 -4,950.00

900-300 · Staff Travel 483.60 1,000.00 -516.40

Total 900-000 · Travel 10,442.45 23,880.00 -13,437.55

904-000 · Insurance

904-100 · Property & Liability Insurance 5,239.09 5,300.00 -60.91

904-150 · Flood Insurance 1,959.00 1,900.00 59.00

904-200 · Insurance-Officers, Directors 1,490.00 1,500.00 -10.00

904-300 · Insurance Workers Comp 806.00 900.00 -94.00

Total 904-000 · Insurance 9,494.09 9,600.00 -105.91

914-000 · Legal 0.00 0.00 0.00

917-000 · Printing

917-400 · Printing - LaFamPac 0.00 400.00 -400.00

917-500 · Printing - Membership 25.71 500.00 -474.29

917-100 · General Printing 550.95 1,000.00 -449.05

Total 917-000 · Printing 576.66 1,900.00 -1,323.34

918-000 · Office Supplies 1,048.49 4,000.00 -2,951.51

924-000 · Postage & Mail Handling

924-700 · Foundation 0.00 0.00 0.00

924-600 · Partnerships 45.59 0.00 45.59 107 Operations Committee Report, continued

General Assembly – July 8, 2016 – Destin, FL

924-500 · Postage for Membership 0.00 0.00 0.00

924-400 · Postage for LaFamPac 0.00 0.00 0.00

924-300 · General Postage 439.56 1,500.00 -1,060.44

924-200 · PR (press release, etc) 0.00 0.00 0.00

924-100 · Postage Meter Rental 986.11 1,400.00 -413.89

Total 924-000 · Postage & Mail Handling 1,471.26 2,900.00 -1,428.74

926-000 · President's Expenses 559.13 3,500.00 -2,940.87

928-000 · Pest Control Services 350.00 500.00 -150.00

930-000 · Building-Repairs & Maint. 658.00 1,000.00 -342.00

931-000 · Equipment-Repairs & Maint. 520.00 500.00 20.00

932-000 · Office Equip. Maint.-Contracts 3,618.11 6,000.00 -2,381.89

933-000 · Ofc/Yd Cleaning & Supplies 1,855.58 3,540.00 -1,684.42

934-000 · Web-Site Maint. 139.00 2,000.00 -1,861.00

941-000 · Telephone 6,705.56 10,260.00 -3,554.44

945-000 · Utilities

945-100 · Electricity (Entergy) 1,662.57 3,000.00 -1,337.43

945-200 · Water 153.96 275.00 -121.04

Total 945-000 · Utilities 1,816.53 3,275.00 -1,458.47

949-000 · Office Equip. (Comp./Upgrade) 1,230.58 2,000.00 -769.42

950-000 · Administrative Meetings 122.19 1,000.00 -877.81

951-000 · Committees

951-600 · RSLCommittee 0.00 100.00 -100.00

951-500 · Board/Committee Mtgs. 431.06 1,000.00 -568.94

951-100 · Education Committee 1,836.00 1,185.00 651.00

951-250 · Legislative & Membership

951-350 · Giveaways/Promotional Items 251.40 3,600.00 -3,348.60

951-320 · Legislative District Breakfast 452.31 3,000.00 -2,547.69

951-310 · First Aid Station 8,632.59 7,175.00 1,457.59

951-290 · Legislative & Advocacy Seminar 0.00 2,000.00 -2,000.00

951-280 · White Coat Day at the Capital 2,509.74 3,000.00 -490.26

951-270 · FM Congressional Conference 0.00 0.00 0.00

951-260 · State Legislative Conference 0.00 2,750.00 -2,750.00

951-250 · Legislative & Membership - Other 3,539.68

Total 951-250 · Legislative & Membership 15,385.72 21,525.00 -6,139.28

951-400 · Operations Committee 0.00 0.00 0.00

Total 951-000 · Committees 17,652.78 23,810.00 -6,157.22

Total Expense 189,661.65 489,890.04 -300,228.39

Net Ordinary Income 220,814.70 1,022.46 219,792.24 Net Income 220,814.70 1,022.46 219,792.24

108 Operations Committee Report, continued

General Assembly – July 8, 2016 – Destin, FL Account Holdings

Balance

LAFP – as of 07/01/2016

Chase Bank - Operating $95,690.58

Chase Bank - Reserve $212,896.68

Chase Bank – Credit Card Account $59,940.73

Chase Bank - National Campaign Fund $1,661.00

TOTAL: $370,188.99

LAFP Foundation – as of 07/01/2016 Chase Bank - Operating $52,285.84 Chase Bank - Savings $3,139.65 Chase Bank - Gehringer CD $14,470.01 Chase Bank - Fleming CD $10,000.00 Tulane Fund $3,950.00 TOTAL: $83,845.50

LaFamPac – as of 07/01/2016

Chase Bank - Operating $4,965.97

GRAND TOTAL: $459,000.46

109 Nominations Committee Report

General Assembly – July 8, 2016 – Destin, FL

Committee on Nominations James A. Taylor, Jr., MD

(1) The Nominating Committee met on June 2, 2016 and reviewed a proposed slate of 2016 - 2017 officers for the LAFP Board of Directors and the LAFP Foundation Board of Directors. The Committee discussed a few options on current active members that could possibly fill any vacant positions. Currently, as shown on the LAFP Board of Directors slate, there are vacancies for alternate directors in District 1 and District 8.

2016-2017 LAFP Board of Directors Nominations

Position Nominee(s) City President James A. Taylor, Jr., MD Zachary President-Elect Jonathan Hunter, MD Alexandria Vice President Tahir M. Qayyum, MD Monroe Secretary Christopher Foret, MD Franklinton Treasurer Bryan Picou, MD Natchitoches Speaker/GA Derek Anderson, MD Baton Rouge Vice Speaker Lisa Casey, MD Metairie AAFP Delegate Russell Roberts, MD, MD Shreveport AAFP Alt. Delegate James Campbell, MD Kenner District 1 Alternate Vacant District 2 – Director Luis Arencibia, MD Metairie District 2 - Alternate Rafael Cortes-Moran, MD Metairie District 3A Director Jack Heidenreich, MD Raceland District 3A Alternate Camille Pitre, MD Larose District 3B Director Indira Gautam, MD Youngsville District 3B Alternate Zeb Stearns, MD Eunice District 6A Director Phillip Ehlers, MD Baton Rouge District 6A Alternate Carol Smothers, MD New Roads District 8 Director Kenneth Brown, MD Alexandria District 8 Alternate Vacant District Director at Large Jody George, MD Lake Charles Alt. District Director at Esther Holloway, MD Coushatta Large Resident Representative James Robinson, MD Lake Charles Resident Alternate Ronnie Slipman, MD Metairie Student Representative Koby Lanclos Shreveport Student Alternate Michael Bacon New Orleans

110 Nominations Committee Report, continued

General Assembly – July 8, 2016 – Destin, FL

(2) The Committee approved the slate of nominations, including the suggested changes made above, and presents the above slate for approval by the General Assembly. The Committee then reviewed the LAFP Foundation Board of Directors slate and approved all nominations to be presented during the General Assembly.

2016-2017 LAFP Foundation Board of Directors Nominations President………………………………………………………………..…..…..…Brian Elkins, MD President-Elect…………………………………………………..…..…... James Taylor, Jr., MD Secretary………………………………………………………………..…….Wayne Gravois, MD Treasurer…………………………………………………………………….…….Bryan Picou, MD Immediate Past President………………………………….……. Melvin Bourgeois, MD Lay Member #1……………………………………………….……………….….…Justin Angelle Lay Member #2……………………………………………….…...... …Barry Dunn Lay Member #3……………………………………………………………….…………Kim Gassie Lay Member #4…………………………………………………………………..…Nadine Robin Lay Member#5……………………………………..…………………………….Kenny Laborde LAFP Member #1…………………………………………………..….E. Edward Martin, MD LAFP Member #2…………………………………………………...... Russell Roberts, MD LAFP Member #3………………………………………………………….………… Jason Fuqua, MD LAFP Member #4……………………………………………….………Jonathan Hunter, MD

(3) Lastly, the Committee reviewed two nominations for 2016 Family Physician of the year. This award will be given to the recipient during the Awards and Installation ceremony scheduled for Saturday, July 9th.

Respectfully Submitted, James A. Taylor, Jr., MD Chair – Nominations Committee

111 Family Medicine Medical School and Match Data

General Assembly – July 8, 2016 – Destin, FL

2016 Family Medicine Medical School and Match Report Ragan LeBlanc

Please see handouts:

- Table 1: Graduating Seniors of Louisiana Medical Schools Who Entered Family Medicine Residencies

- Table 2: Louisiana Family Medicine MATCH 2016

- Table 3: Louisiana Medical School Seniors - 2016 Match Specialty Choices, In-State vs. Out-of- State Residency, PC Projection

112 TABLE 1: Graduating Seniors of Louisiana Medical Schools Who Entered Family Medicine Residencies 36 Classes, from 1981 thru 2016

80-81 81-82 82-83 83-84 84-85 85-86 86-87 87-88 88-89 89-90 90-91 91-92 92-93 93-94 94-95 95-96 96-97 97-98 98-99 99-00 00-01 01-02 02-03 03-04 04-05 05-06 06-07 07-08 08-09 09-10 10-11 11-12 12-13 13-14 14-15 15-16 La TOTALS 81 thru 16 LSU-NO # graduates 178 171 173 178 178 178 157 162 179 153 163 165 174 159 184 161 179 160 160 179 169 166 161 176 166 159 154 158 166 166 182 171 180 175 175 182 6,097 # Entering FM 20 15 22 20 21 23 12 9 14 10 5 11 13 28 29 16 28 23 22 20 14 13 9 11 15 13 4 5 14 13 18 14 11 18 16 14 563 % class in FM 11.2% 8.8% 12.7% 11.2% 11.8% 12.9% 7.6% 5.6% 7.8% 6.5% 3.1% 6.7% 7.5% 17.6% 15.8% 9.9% 15.6% 14.4% 13.8% 11.2% 8.3% 7.8% 5.6% 6.3% 9.0% 8.2% 2.6% 3.2% 8.4% 7.8% 9.9% 8.2% 6.1% 10.3% 9.1% 7.6% 9.2% LSU-NO's 36 yr longitudinal annual average entering FM: 15.6

LSU-Shreveport # graduates 86 98 98 95 101 102 92 86 96 87 92 93 90 96 96 90 100 97 90 99 93 96 96 99 100 93 95 97 104 111 108 100 117 108 115 118 3,534 # Entering FM 12 11 13 20 18 16 9 8 8 8 8 11 11 16 19 18 23 17 12 13 7 18 14 12 8 12 13 7 11 9 14 6 9 11 5 4 431 % class in FM 14.0% 11.2% 13.3% 21.1% 17.8% 15.7% 9.8% 9.3% 8.3% 9.2% 8.7% 11.8% 12.2% 16.7% 19.8% 20.0% 23.0% 17.5% 13.3% 13.1% 7.5% 18.8% 14.6% 12.1% 8.0% 12.9% 13.7% 7.2% 10.6% 8.1% 13.0% 6.0% 7.7% 10.2% 4.3% 3.3% 12.2% LSU-S's 36 yr longitudinal annual average entering FM: 12.0

Tulane # graduates 152 156 150 150 143 147 140 156 149 141 140 146 148 142 121 148 140 140 150 146 149 145 153 155 143 146 140 151 133 155 167 183 164 169 172 192 5,422 # Entering FM 4 6 9 10 3 7 4 6 3 2 6 5 13 14 5 14 7 12 10 12 14 10 12 14 13 14 9 10 10 12 21 24 11 16 13 14 369 % class in FM 2.6% 3.8% 6.0% 6.7% 2.1% 4.8% 2.9% 3.8% 2.0% 1.4% 4.3% 3.4% 8.8% 9.9% 4.1% 9.5% 5.0% 8.6% 6.7% 8.2% 9.4% 6.9% 7.8% 9.0% 9.1% 9.6% 6.4% 6.6% 7.5% 7.7% 12.6% 13.1% 6.7% 9.5% 7.6% 7.3% 6.8% TU's 36 yr longitudinal annual average entering FM: 10.3

SUMMARY Total Louisiana Graduates, 36 classes, '81 thru '16 15,053 # Who Entered Family Medicine 1363 % of Graduates entering FM 1981-2016 9.05%

TABLE 1a. Match Day Stats, Louisiana and US Fam Med Residencies

83-84 84-85 85-86 86-87 87-88 88-89 89-90 90-91 91-92 92-93 93-94 94-95 95-96 96-97 97-98 98-99 99-00 00-01 01-02 02-03 03-04 04-05 05-06 06-07 07-08 08-09 09-10 10-11 11-12 12-13 13-14 14-15 15-16

FM PGY 1 - Total # Positions offered by all LA FMRPs in the Match 32 37 39 42 47 51 64 73 63 63 57 56 57 52 53 51 54 57 61 60 62 68 69 69 68 FM PGY 1 - Total #PGY1 Positions offered by all LA FMRPs for July 1 64 63 66 65 67 68 69 69 68 FM PGY1 - # Positions Filled in La FMRPs on Match Day 10 20 22 18 29 40 52 45 45 36 35 32 39 36 49 41 42 49 41 57 50 63 66 61 63 Match Day FM Fill Rate (%) in La 31.3% 54.1% 56.4% 42.9% 61.7% 78.4% 81.3% 61.6% 71.4% 57.1% 61.4% 57.1% 68.4% 69.2% 92.5% 80.4% 77.8% 86.0% 68.9% 95.0% 80.6% 92.6% 95.6% 88.4% 92.6% Match Day FM Fill Rate (%) in US 70.4% 65.9% 67.5% 77.3% 82.7% 87.1% 90.5% 89.1% 85.5% 82.6% 81.2% 76.3% 79.0% 76.2% 78.8% 82.4% 85.0% 88.2% 90.6% 91.2% 91.4% 94.4% 94.5% 96.0% 95.8% 95.1% 95.2% Match Day FM Fill Rate with US Seniors (%) in US 57.2% 49.0% 47.4% 42.0% 41.5% 40.7% 41.5% 42.2% 44.2% 42.4% 45.0% 48.2% 43.3% 44.9% 45.2% 44.2% 45.4% % of All Graduating US Seniors Matching into FM, 1984-2016 14.4% 13.3% 13.8% 14.8% 11.1% 11.1% 10.9% 10.6% 10.8% 12.6% 14.0% 15.4% 17.0% 17.3% 16.0% 14.8% 13.6% 11.2% 10.5% 9.2% 8.8% 8.2% 8.1% 7.8% 8.2% 7.4% 7.9% 8.4% 8.5% 8.4% 8.6% 8.4% 8.7%

Source: American Academy of Family Physicians & Deans Offices of LSU-NO, LSU-S, Tulane Complied by Ragan LeBlanc, LAFP COPYRIGHT

113 TABLE 2: Louisiana Family Medicine MATCH 2016 ----- Applications & Interviews ------Breakdown of New PGY 1's ----- Final Prg size for 7/15 VISAs DO Apprvd Total PGY1Total PGY1 # slots # PGY1 # PGY1 slots Ttl PGY 1GY1 Applications for July PGY1 Applicants Interviewed MD's DO's US Srs IMGs IMGs who US Citzns PGY1 PGY2 PGY3 PGY4 PGY5 PRGM Visa Holders Accrd Notes Residency slots offrd Slots Listed filled Scrambld? slots filled filld outside slots filled Total DO Srs Total US MD La Sch IMGs IMG IMGs who are IMGs who TOTAL in prgrmas of 4/1/13 July 1st in Match in Match Yes=1 in scrmble Mtch/Scrmble 7/1/2015 Srs Srs (all) US-Citzns Frm LA US Citzns are frm La J1 Visa H1 Visa

Alex 6 6 6 6 1722 0 55 9 7 46 45 20 6 0 0 6 6 4 6 6 6 18 NO Bogalusa 6 6 6 6 1282 0 64 22 15 42 63 14 6 0 2 4 4 0 6 6 7 19 NO BR Gen 8 8 8 8 1469 0 70 30 15 40 40 9 7 1 6 2 2 1 8 8 8 24 YES East Jeff 7 7 7 7 1095 15 72 55 31 18 16 7 5 2 6 1 6 1 7 7 7 21 YES Kenner 6 6 5 1 1 6 2063 0 50 30 16 20 20 7 5 1 4 2 2 1 6 8 4 18 YES Lafayette 8 8 8 8 1346 8 44 15 13 29 42 0 8 0 2 6 8 3 8 8 8 24 NO Lk Charles 8 8 6 1 2 8 1331 8 57 27 22 30 14 4 6 2 3 5 0 0 8 8 8 24 YES Monroe 8 8 8 8 2003 4 41 12 6 25 19 11 8 0 2 6 4 2 8 8 8 24 NO Shrev** 6 6 6 1 6 1714 0 6 0 0 6 2 0 6 6 6 18 NO Shrev-Rural** 3 3 1 1 3 3410 0 3 0 0 2 1 0 3 3 3 9 NO Shrev FM-EM** 2 2 2 1 2 2 171 0 102 0 11 75 55 8 2 0 2 1 2 0 2 2 2 2 2 13 NO TOTALS 68 68 63 5 68 17606 35 555 200 136 325 314 80 62 6 27 41 37 12 68 70 67 2 2 209

MATCH DAY SUMMARY PROFILE 2016 2015 2014 2013 2012 2009 2008 2007 2006 2005 2004 2003 2002 2001 US FM Match fill rate on Match Day = 95.20% 95.10% 95.80% 96.0% 94.50% 91.2% 90.6% 88.2% 85.0% 82.4% 78.8% 76.3% 79.0% 76.3% La FM Match fill rate on Match Day = 92.60% 88.40% 95.60% 92.6% 92.6% 86.0% 77.8% 80.4% 92.5% 69.2% 68.4% 57.1% 61.4% 57.1% % of new La FM PGY1 who are US Seniors 39.70% 34.80% 40.60% 36.7% 39.7% 39.7% 29.7% 27.9% 44.6% 45.6% NA NA NA NA % of new La FM PGY1 who are IMGs 60.30% 65.20% 59.40% 63.2% 60.3% 60.3% 70.3% 73.8% 55.4% 54.4% NA NA NA NA % of new La FM PGY1 IMGs who are US Citizens 54.40% 91.10% 75.60% 88.3% 90.2% 57.9% 62.2% 60.0% 48.4% 58.1% NA NA NA NA % of new La FM PGY1 US Citz IMGs from La 17.60% 12.20% 35.40% 15.8% 32.4% 95.5% 35.7% 51.9% NA NA NA NA NA NA

Total # FM residents in training in La, by Academic Year 15-16 14-15 13-14 12-13 11-12 10-11 09-10 08-09 07-08 06-07 05-06 PGY 1's 68 69 69 68 68 68 65 65 64 56 59 PGY 2's 70 70 69 70 66 63 71 65 57 37 55 PGY 3's 67 70 65 67 62 66 64 60 51 31 53 ALL Years 205 209 203 205 196 197 200 190 172 124 167

# La FM resdents w/ J-1 or H-1 Visa NA % of LA FM residents with VISA NA

Med Schools of 2016 incoming IMG PGY1s Med Schools of 2016 incoming US Grad PGY1s American Universtiy of Antigua 4 LSUHSC-New Orleans 5 American University of the Carribean 4 LSUHSC-Shreveport 4 SUMMARY, Residency Class starting 2016 Avalon 2 Loyola 1 Changalpattu Medical College 1 Tualne 6 Total 68 new PGY1's Galway School of Medicine 1 Subtl from LA Med Schls 16 Interanational American University 2 Total Medical University of the Americas 7 Mercer 2 Ross University 7 PA College of Osteopathic Medicine 2 IMGs of all PGY1's Saba University 2 Touro College of Osteopathic Medicine 1 US Citizens = 37 (from La = 17) San Juan Bautista 1 Meharry 2 Non Citizens = 31 St. George 1 University of New Mexico 1 St. Kitts 4 Universtiy of Texas 2 US Srs of all PGY1's Subharati Medical College 1 Willam Carey University College of Osteopathic Med 3 La Schools = 16 Trinity School of Medicine 1 Subtl from other US schools 13 Non-La Schools=13 University of Queensland 1 Total 39 Total 29 Copyright

114 TABLE 3: Louisiana Medical School Seniors - 2014 Match Specialty Choices, In-State vs Out-of-State Residency, PC Projection 3 DISCIPLINE LSU-NO LSU-S Tulane ALL STATE Projected "In-La" (Potential PC fields in pink) In La Outst TOTAL In La Outst TOTAL In La Outst TOTAL In La Outst TOTAL % of ttl PC MDs from cohort 1 Anesth 6 10 16 2 6 8 0 12 12 8 28 36 7.3% 2 Derm 0 1 1 3 1 4 1 1 2 4 3 7 1.4% 3 Emerg Med 5 4 9 5 2 7 2 17 19 12 23 35 7.1% 4 Emerg Med /Trans 0 0 0 0.0% 5 Emerg Med /FM 1 2 3 0 1 1 1 3 4 0.8% 6 Emerg Med /IM 0 2 2 0 2 2 0.4% 7 Fam Med 5 9 14 4 0 4 5 9 14 14 18 32 6.5% 8 Internal Medicine - Prelim 0 0 0 0.0% 9 Internal Medicine 7 13 20 4 37 41 11 50 61 12.4% 10 Medicine - Categorical 21 18 39 21 18 39 7.9% 11 Medicine - Prelim 11 3 14 1 2 3 12 5 17 3.5% 12 Medicine - Primary 0 3 3 0 3 3 0.6% 13 Medicine/Derm 0 0 0 0.0% 14 Medicine/FMMD 0 0 0 0.0% 15 Medicine/Neuro 0 0 0 0.0% 16 Medicine/Peds 0 4 4 1 4 5 1 3 4 2 11 13 2.6% 17 Medicine/Psych 0 0 0 0.0% 18 Neurol 3 3 6 0 8 8 3 11 14 2.8% 19 Neurol Child 0 3 3 0 1 1 0 4 4 0.8% 20 Neurol Surg 3 1 4 1 1 2 4 2 6 1.2% 21 OB/GYN 4 3 7 6 6 12 0 6 6 10 15 25 5.1% 22 OB/GYN - Prelim 0 0 0 0.0% 23 Opthalmol 1 2 3 0 2 2 1 4 5 1.0% 24 Ortho - Surgery 0 3 3 1 3 4 2 5 7 3 11 14 2.8% 25 OtoLaryn 1 2 3 0 3 3 0 2 2 1 7 8 1.6% 26 P M & R 5 0 5 0 2 2 5 2 7 1.4% 27 Pathology 1 1 2 0 1 1 1 4 5 2 6 8 1.6% 28 Peds 6 7 13 5 7 12 2 12 14 13 26 39 7.9% 29 Peds - Primary 0 0 0 0.0% 30 Peds/EM 0 0 0 0.0% 31 Peds/Psych 0 1 1 0 1 1 0.2% 32 Psych 5 3 8 4 1 5 0 8 8 9 12 21 4.3% Psych/FM 0 1 1 0 1 1 0.2% 33 Radiol - Dx 3 0 3 0 3 3 2 7 9 5 10 15 3.0% 34 Radiol- Oncol 0 4 4 0 4 4 0.8% 35 Surgery - General 2 4 6 2 9 11 0 16 16 4 29 33 6.7% 36 Surgery - Prelim 10 4 14 0 2 2 1 3 4 11 9 20 4.1% 37 Surgery- Plastics 1 1 2 0 1 1 0 1 1 1 3 4 0.8% 38 Surgery - Thor 0 0 0 0.0% 39 Surgery- Vasc 0 0 0 0.0% 40 Transitional 0 2 2 0 1 1 0 2 2 0 5 5 1.0% 41 Urology 0 3 3 0 1 1 0 4 4 0.8% 42 Oral Surgery/MD Program 2 2 4 2 2 4 0.8% 43 Research or Advanced degree 0 0 0 0.0% 44 No position (atched, scrambled 0 1 1 0 1 1 0.2% TOTALS 4 93 89 182 44 74 118 22 170 192 159 333 492 100.0% In State vs Out of State %'s 51.0% 48.0% 37.0% 63.0% 11.0% 89.0% 32.0% 68.0% Notes: 1) Data provided/confirmed by each school and/or posted on web 2) For students who matched with a preliminary year program AND a subsequent program AND a subsequent categorical residency, only categorical program (ie, their eventual specialty) & its locale is reported above. 3) Projected "In-La PC MDs" totals are in pink in far right column. Calculation sums highlighted sections (PC totals) & adjusts total based on published rates of "attrition from PC" (attrition for FM= 91%, IM=20%, Ped=44%, Med/Ped=50%) then multiplies by historical retention rate in La of 50% (for all those entering PC careers whether doing La or non-La residency). Final figures for PC docs entering a PC practice in LA are a projection for 3-4 years in the future, when this cohort completes residency. 115 4) Grads in row 42, 43 and 44 ("Oral Surgery/MD Program, Research, Advncd Degree, No Match or Scrambled Position") are not included in 'In La' or 'Outst' subtotals, only in Totals. Data as of 05-2016 Call for Nominations of LAFP Officers

General Assembly – July 8, 2016 – Destin, FL 2016-2017 LAFP Officer and Board Nominations Position Nominee(s) City President James A. Taylor, Jr., MD Zachary President-Elect Jonathan Hunter, MD Alexandria Vice President Tahir M. Qayyum, MD Monroe Secretary Christopher Foret, MD Franklinton Treasurer Bryan Picou, MD Natchitoches Speaker/GA Derek Anderson, MD Baton Rouge Vice Speaker Lisa Casey, MD Metairie AAFP Delegate Russell Roberts, MD, MD Shreveport AAFP Alt. Delegate James Campbell, MD Kenner District 1 Alternate Vacant District 2 – Director Luis Arencibia, MD Metairie District 2 - Alternate Rafael Cortes-Moran, MD Metairie District 3A Director Jack Heidenreich, MD Raceland District 3A Alternate Camille Pitre, MD Larose District 3B Director Indira Gautam, MD Youngsville District 3B Alternate Zeb Stearns, MD Eunice District 6A Director Phillip Ehlers, MD Baton Rouge District 6A Alternate Carol Smothers, MD New Roads District 8 Director Kenneth Brown, MD Alexandria District 8 Alternate Vacant District Director at Large Jody George, MD Lake Charles Alt. District Director at Esther Holloway, MD Coushatta Large Resident Representative James Robinson, MD Lake Charles Resident Alternate Ronnie Slipman, MD Metairie Student Representative Koby Lanclos Shreveport Student Alternate Michael Bacon New Orleans

116 Call for Nominations of LAFP Foundation Officers

General Assembly – July 8, 2016 – Destin, FL

2016-2017 LAFP Foundation Board of Directors Nominations

President………………………………………………………………..…..…..…Brian Elkins, MD President-Elect…………………………………………………..…..…... James Taylor, Jr., MD Secretary………………………………………………………………..…….Wayne Gravois, MD Treasurer…………………………………………………………………….…….Bryan Picou, MD Immediate Past President………………………………….……. Melvin Bourgeois, MD Lay Member #1……………………………………………….……………….….…Justin Angelle Lay Member #2……………………………………………….…...... …Barry Dunn Lay Member #3……………………………………………………………….…………Kim Gassie Lay Member #4…………………………………………………………………..…Nadine Robin Lay Member#5……………………………………..…………………………….Kenny Laborde LAFP Member #1…………………………………………………..….E. Edward Martin, MD LAFP Member #2…………………………………………………...... Russell Roberts, MD LAFP Member #3………………………………………………………….………… Jason Fuqua, MD LAFP Member #4……………………………………………….………Jonathan Hunter, MD

117 District Director/Alternate Director Reports

General Assembly – July 8, 2016 – Destin, FL

District 1 – Mary Coleman, MD/Vacant - No written report submitted.

District 2 - Daniel Jens, MD/Luis Arencibia, MD - No written report submitted.

District 3A – Jack Heidenreich, MD/Camille Pitre, MD - No written report submitted.

District 3B – Indira Gautam, MD/Zeb Stearns, MD - No written report submitted.

District 4 - Ricky Jones, MD/Gregory Bell, MD - No written report submitted.

District 5 – Tobe Momah, MD/James Smith, MD - No written report submitted.

District 6A – Phillip Ehlers, MD/Carol Smothers, MD - No written report submitted.

District 6B – Richard Bridges, MD/Keisha Harvey, MD - No written report submitted.

District 7 – Jason Fuqua, MD/Andrew Davies, MD - No written report submitted.

District 8 – Jonathan Hunter, MD/Matthew Erickson, MD - No written report submitted.

District Director at Large – Jody George, MD/Esther Holloway, MD – No written report submitted.

118 Family Medicine Department Report – LSUHSC New Orleans

General Assembly – July 8, 2016 – Destin, FL

LSUHSC—New Orleans Family Medicine Department Department Chair: Mary Coleman, MD

Department Update This past year, under the leadership of Dr. Mary Coleman, the Department of Family Medicine at LSU-NO introduced several innovations. The interprofessional student care management program for patients with diabetes (DIME) expanded from University Medical Center by adding Riverdale school-based clinic as a site at which teens with diabetes and pre diabetes are given health care coaching. Dr. Pam Wiseman has secured funding from the Humana Foundation to expand the program this coming year even further within the school system. In addition, the Family Medicine department piloted a longitudinal experience for two students who were given the opportunity throughout their required third year rotations to spend a half day a week in a primary care setting. This longitudinal program is also expanding this year. The department, under the leadership of Drs. Russo and Seeliger, are launching a global health elective and the first learners and faculty will travel to Peru to provide services this year. The department held a clerkship retreat in Baton Rouge with representatives from 4 LSU residency programs and Dr. Hood from Shreveport to determine ways to improve the clerkship.

Medical Students Choosing Family Medicine The faculty and community preceptors continued to provide a valuable educational experience in family practice for the junior and senior students. The students value their experience with practicing family physicians and the number of students choosing Family Medicine as a career was 14. Of those 14 students, 5 have stayed in Louisiana to train. Here are the students and their training institution: Name Institution Name Arcelao, Richard North Florida Regional Med Ctr Barras, Glenn Resurrection Health-TN Bertucci, Michael McLeod Reg Med Ctr-SC Boyd, Duston Resurrection Health-TN Braud, Peter Trident Medical Center-SC Coleman, Stephanie Baton Rouge Gen Med Ctr-LA Fuselier, Danielle University Hospital & Clinics-LA Halapin, Natalie Montana Family Medicine Juakali, Ebony Forrest General Hospital-MS Juneja, Vinay Palmetto Health Richland-SC Lee, Soojung U Alabama Tuscaloosa Mann, Matthew Baton Rouge Gen Med Ctr-LA Ortiz, Alicia University Hospital & Clinics-LA Shoenfelt, Abigail LSUHSC Lake Charles-LA

Report of LSUHSC Rural Scholars Track The LSUHSC Rural Scholars Track is proud to announce the graduating class of 2016:

Stephanie Ray (December Graduate) 119 Family Medicine Department Report – LSUHSC New Orleans, continued

General Assembly – August 7, 2015 – New Orleans, LA

Rick Faul Daniel Fuselier

This recent class brings the total number of additional primary care physicians produced through RST to 61 since the first graduation class of 2005. Of the 61 graduates 25 are currently residents or fellows and 36 are currently practicing. We are very excited about these numbers, as the program is over a decade old.

Faculty Publications The faculty contributed to the literature with several articles published in 2016.

Coleman MR, Coleman MT (2015) “Dairy-Free” dietary Substitute, Abdominal Pain, and Weight Loss. Clin Med Rev Case Rep 2:079.

Headrick LA, Ogrinc G, Hoffman KG, Stevenson KM, Shalaby M, Beard AS, Thorne K. Coleman MT, Baum, K. (2016) Exemplary Care and Learning Sites: A Model for Achieving Continual Improvement in Care and Learning in the Clinical Setting. Academic Medicine, March ; 91(3):354-9.

Rubin, Susan, Coy, Lauren, Yu, Qingzhao, Muncie, Herbert (2016) “Louisiana and Mississippi family physician’s contraception counseling for adolescents with a focus on intrauterine contraception”: Journal of Women’s Health.

Muncie, Herbert, Russo, Emilio, Mohr, Jeff (2015) “Autism Spectrum Disorder”: Springer International Publishing

Muncie, Herbert, Oge, Linda, Anderson, Garland (2015) “Care of the Alcoholic Patient”: Springer International Publishing

Respectfully Submitted, Mary T. Coleman, MD, PhD Department Chair

120 Family Medicine Department Report LSUHSC – Shreveport

General Assembly – July 8, 2016 – Destin, FL

LSUHSC—Shreveport Family Medicine Department Department Chair: Michael Harper, MD

We continue to have uncertainty regarding the partnership between LSU and University Hospital (Biomedical Research Foundation). While the relationship improved over the last six months, the state budget crisis and recent change in LSU leadership leave lots of questions unanswered, including some lingering legal battles. Although the continued uncertainty has strained morale throughout the school and hospital, we are fully staffed, our residencies are doing well, and a new class of medical students is in the Comprehensive Care Clinic.

Our residency programs in Shreveport, Vivian, Alexandria, and Monroe are full and doing well. See the individual reports for details. Our undergraduate medical education program has now completed six years of a new curriculum that includes a required 3rd year clerkship with practicing family physicians. This is a great opportunity for our third year medical students to see family medicine in the “real world” and encourage them to consider family medicine as a specialty. We are very grateful for those family doctors who continue to participate in this important program. You are helping to train future family physicians for Louisiana!

We have expanded our faculty clinic and our faculty now staff an urgent care clinic operated by University Hospital Shreveport. We are planning to open a sports medicine clinic with the ultimate goal of starting a Sports Medicine Fellowship.

We had a great 40 year celebration of the Shreveport Family Medicine residency on October 10, 2015. This reunion was attended by many of our residency graduates and former faculty members. Also present were all living former chairmen of the department: Dr. Ike Muslow, Dr. Rozelle Hahn, and Dr. Arthur Fort. We learned a lot about the history of the department from them, with help from Sarah Miller who retired in December 2015.

Our department has continued the Global Health program at the LSU School of Medicine in Shreveport. We completed two months of school sponsored international electives in Kenya in February and April of this year. Students and residents are supervised by our faculty in clinics located in rural Western Kenya in partnership with SHIP and Volunteer Kenya. We presented two posters at the AAFP Global Health Workshop, October 2-3, 2015 in Denver.

Respectfully Submitted, Michael Harper, MD Department Chair

121 Family Medicine Department Report – Tulane

General Assembly – July 8, 2016 – Destin, FL

Tulane University School of Medicine Family Medicine Department Department Chair: Edwin Dennard, MD

LAFP Annual Report AY 2015-2016

The academic year 2015-2016 has been another one marked by transition and renewal for the Department of Family and Community Medicine at Tulane.

Tulane Family Medicine 2016 Match Results Tulane matched 18 students into family medicine residency programs this year. We thank all of our all preceptors for their integral role in guiding and educating our students and hope to honor those who mentored the students who have decided to join our discipline. Match results - Louisiana residency programs are in bold type, and students from the Rural Immersion Program (TRIP) are indicated by an asterisk - were as follows:

Students Match Site Preceptor/Site Lora Langenfels MD / New Amanda Belcher Chippenham Medical Center, Richmond, VA Orleans Alex Bernadett* Swedish/First Hill, Seattle, WA Steve Vidrine MD / Ville Platte Frank De Paula Memorial Hermann Hospital, Sugarland, TX David Euans MD / Metairie Contra Costa Regional Medical Center, Martinez, Jacques Sanders MD / Kevin Dolezal CA Prairieville Nicole Gentile University of Washington, Seattle, WA Rade Pejic MD/ New Orleans Richard Harmon MD / Patrick Fitz-Gerald Anderson Area Medical Center, Seneca Lakes, SC Opelousas Matthew Hallowell LSU School of Medicine, Kenner, LA Brian LeBlanc MD / New Roads Dewan Majid University of Kansas, Kansas City, KS David Ware MD/ Eunice Claire McKinley University of Iowa, Iowa City, IA James Taylor MD / Livingston Contra Costa Regional Medical Center, Martinez, Catherine Nguyen CA John Fraiche MD / Gonzales Emmanuelle Noar* Providence Hospital, Washington, D.C. Lou McCormick MD/ Franklin Charla Poole LSU Health Sciences Center, Monroe,LA Albert Kerr MD / Rayville Vidant Medical Center/East Carolina University, Delora Denney MD / Picayune, Jessica Provo Greenville, NC MS Michael Felton MD / Church Amanda Rogers* LSU School of Medicine, Bogalusa, LA Point Drazen Sosic LSU School of Medicine, Bogalusa, LA Nick Seeliger MD / Metairie Thomas Santamaria East Jefferson General Hospital, Metairie, LA Jose Veras Pola MD/ Kenner Brian Templet East Jefferson General Hospital, Metairie, LA Brian LeBlanc MD / New Roads Danielle Wisniewski Sutter Medical Center, Santa Rosa, CA Jim Theis MD / Marrero

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Medical Student Awards The Scott Gregory Kramer M.D. Family Medicine Award is given annually to the graduating senior with the highest class-rank who is pursuing a career in Family Medicine. This year’s award went to Danielle Wisniewski, M.D. Dr. Wisniewski grew up in San Diego and attended U.C. Berkeley as an international development major, which led her to discover medicine and “that being a doctor was going to be my way of fixing things.” During and following college, Dr. Wisniewski worked in South America, assisting in community clinics and becoming fluent in Spanish. At Tulane, Dr. Wisniewski served as the Vice President of the Latin American Student Association, as a member of the Family Medicine Interest Group and as a coordinator for the Tar Wars anti-tobacco program in one of our community public schools. She organized a medical school elective on social contexts in medicine, which involved participating students in the medical care of our local “hot spotters” - marginalized patients with poor adherence to medical treatment and follow up. Perhaps the signal accomplishment in Dr. Wisniewski’s career at Tulane has been her election into the Gold Humanism Honor Society (GHHS). The GHHS has an exclusive membership; only about 5% of a class may be elected to the GHHS, and this is done by peers who nominate and vote on personality attributes such as warmth, bedside manner, empathy and placing the interests of others above self. Election to the GHHS is a very high honor at Tulane. Dr. Wisniewski starts her family medicine residency on July 1 at the Sutter Medical Center in Santa Rosa, California.

The Tulane/LAFP Family Medicine Excellence Award is given annually to the graduating senior who is entering a career in family medicine and demonstrates commitment to high quality, patient-oriented, continuity, and preventive care across the spectrum of age, disease, and health. This year, the award went to Nicole “Nikki” Gentile, M.D. Dr. Gentile attended U.C. Davis, where she earned a PhD in comparative pathology and entered Tulane as part of the first Heal-X class. The Heal-X program admits to the Tulane School of Medicine students with a doctorate in the sciences to complete their pre-clinical studies in an accelerated 18-month curriculum. During her career at Tulane, Dr. Gentile has been an enthusiastic advocate for her colleagues, for the discipline of family medicine, and for her community. She served as secretary of the Family Medicine Interest Group and became its advisor during her last year at Tulane. She also served as an alternate student delegate from the LAFP to the AAFP national meeting. Dr. Gentile has participated in numerous medical missions in Guatemala, where she attained proficiency in Spanish, and was elected to the editorial board of the Annals of Family Medicine during her fourth year of medical school. Dr. Gentile will start her family medicine residency on July 1 at the University of Washington in Seattle.

Department Leadership, Faculty Changes Eddie Dennard remains department chairman, where he continues to oversee all aspects of the department’s clinical, teaching and research missions. The department is actively recruiting new faculty members.

Rade Pejic remains director of the department’s clinical affairs and family medicine clerkship. As director of the family medicine clerkship, Dr. Pejic will continue an ongoing multi-year review and update of our teaching curriculum and expansion of our preceptor faculty network, the latter made possible in part by the Ernest G. DeBakey Rural Education Fund.

Clare Hoff continues as director of the preventive medicine residency, which has been invigorated this year with the award of a training grant from the Health Resource and Service Administration. Kiernan Smith has taken over as director of SAPORO, a practice-based research network formed in 2014. SAPORO completed its initial study in 2015, which culminated in a Research Day on the Tulane campus in September 2015. Attending the Research Day were many of the study participants and a visiting professor, Dr. Sandra Burge, who directs several practice-based research networks based at the University of Texas Health Sciences Center in San Antonio. Under Dr. Smith’s leadership work has begun on a second study, this to determine the type, frequency of use and efficacy of Smartphone health applications for weight loss. SAPORO is planning for a Research Day in September 2016 to report the current study results and to plan for a future study in 2017.

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We are pleased to welcome a new faculty member, Rebekah Byrne, MD, MPH. Dr. Byrne attended Tulane for undergraduate and medical school and trained in family medicine at Swedish/First Hill in Seattle, Washington. Dr. Byrne completed a fellowship in integrative care in Seattle and hopes to establish an active consult clinic in integrative care in addition to her clinic in general family medicine. We are also pleased to welcome Adam Peltz, who succeeds Joy Gilhousen as our clerkship coordinator. Prior to joining the department, Mr. Peltz was the Academic Counselor in the College of Liberal Arts at The University of New Orleans, where he also received his M.F.A. in 2004.

On a sadder note, Paula Singleton Lucas, PhD, our very able and committed department administrator, succumbed to cancer in May. Dr. Lucas came to Tulane in 1993, where she started her career as an executive secretary and worked her way up the ladder to department administrator in dermatology, and then senior department administrator for the Department of Family and Community Medicine. She held an appointment as Adjunct Assistant Professor in our department and actively participated in the clerkship curriculum. Dr. Lucas was an active service contributor to our community, participating in service days for the university and supporting her church and its members. Most recently, she founded “Wave Helping the Brave”, a campaign to raise money for the local fire station that serves the downtown Tulane community. Dr. Lucas’ passing is a loss to the department, the university and the community she served so tirelessly and well.

Preventive Medicine Residency. This year, the Preventive Medicine Residency Program received a Health Resource and Service Administration training grant. The grant will fund substantial portions of the training costs for six (6) preventive care residents over the next 3 years and has allowed the program to recruit new residents and expand its curricular offerings and training sites. The residency is actively seeking new training opportunities in rural Louisiana.

Ernest G. DeBakey Rural Education Fund. We continue to work at expanding the department’s preceptor network in rural Louisiana through a generous gift that established the Ernest G. DeBakey Rural Education Fund. This fund assists in paying for housing and internet access to allow more Tulane medical students to experience the rewards of primary-care practice in rural communities of the Gulf South.

Tulane Rural Immersion Program. During 2013, we modified TRIP to make it sustainable with existing department resources after the grant funding expired in July 2013. The modified TRIP continues to provide an opportunity for self- motivated students to complete many of their core clerkships imbedded in a rural community in Louisiana. We matriculated six (6) students in the modified TRIP during the 2015 - 16 academic year. Our department and school owe a special debt of gratitude to our family medicine and specialty preceptors in the communities of Franklin, Opelousas, New Iberia, Church Point and Ville Platte, who made this possible.

Tulane Medical Home Curriculum Project. In the upcoming year, we will continue to refine new teaching modules in communications skills, quality improvement, the chronic disease model, and preventative medicine. We are planning to add a teaching module in integrative care and continue to build on past efforts to integrate patient-centered medical home principles and interactive and distance learning into all aspects of the clerkship teaching.

Third-Year Clerkship and Electives. In the 2015-2016 academic school year, the clerkship has continued its work to replace the traditional family medicine clerkship curriculum with a more hands-on and interactive learning format. We have made several substantial changes for the coming year, 2016-2017. Students will spend the first week of the six- week clerkship participating in team-based, case-based and simulation-based learning sessions. We believe that this format will better prepare students for their clinical rotation in family medicine. Additionally, we have removed the requirement to complete a student project. Instead, students are encouraged to prepare more for the final examination, which is a national board style exam. We will continue with the Patient-Centered Medical Home as the organizing principle of the curriculum, emphasizing skill sets that prepare students to function optimally in the primary care clinic of the future. We continue to coordinate international electives and to conduct a popular T4 elective in the business of medicine. 124 Family Medicine Department Reports - Tulane, continued

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Our department and school owe a special debt of gratitude to our family medicine preceptors in communities throughout Louisiana and coastal Mississippi and Alabama. In addition, we owe a special debt of gratitude to our affiliate residencies – the Baton Rouge General Family Medicine Residency and the East Jefferson General Hospital Family Medicine Residency – for their help in many aspects of our teaching mission in the medical school.

Faculty, fellows and residents have donated both time and energy to assist in interactive teaching in the musculoskeletal examination and lectures in pharyngitis, upper respiratory infection, prostate screening and congestive heart failure. They have also assisted in grading student projects and have attended our career day activities with students interested in matching in Family Medicine residencies.

Owl Club Awards. Owl Club is the student-run organization that evaluates based on student feedback clerkship and teaching throughout the four-year curriculum of the school of medicine. At this year’s award ceremony, the department received following awards:  Best Family Medicine Preceptor – Jim Theis, MD  Best Clerkship Coordinator – Adam Peltz

Respectfully Submitted, Edwin W. Dennard, MD Department Chair

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Family Medicine Residency Program Director Reports

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LSUHSC - Shreveport at Alexandria Family Medicine Residency Program Program Director: Robert Moore, MD

2016 marks the 20th anniversary of the Alexandria based Family Medicine Residency Program. Established by a grant through The Rapides Foundation, the program continues through a cooperative endeavor between LSU Health – Shreveport and Rapides Regional Medical Center / HCA. Our clinic provides medical care to more than 6,000 patients with over 25,000 clinic visits annually. The procedural practice was expanded this year to include a wide variety of dermatologic services. In addition to busy inpatient services at Rapides Regional Medical Center and Rapides Women’s & Children’s Hospital our faculty and residents provide wound care services and volunteer at community-based events.

Including the Class of 2016 the program has produced 105 graduates. Seventy percent practice in rural or underserved areas of Louisiana where their services are most urgently needed. We are pleased to announce that Dr. Micah Pippin, a member of the graduating class and Chief Resident, has accepted a faculty position with our program. Dr. Pippin is originally from Alexandria and a Tulane School of Medicine graduate, where he was part of the TRIP rural immersion program. He was chosen as the 2013 Gladney Endowment Fund recipient; the award honors physicians for their dedication to medicine and their efforts to encourage physicians to enter rural family medicine. The program is currently seeking to hire one additional faculty member.

Two of our residents took home honors in the Department of Family Medicine Annual Research Poster Competition. Dr. Cary Bybee received the First Place Award & Program’s Director’s Choice Award for his poster on “Diabetic Foot Infection: Passive Management = Amputation”. Dr. Juan Pascual received third place for his presentation of “Pharyngitis with Scarlet Fever”. Dr. Llewellyn Mensah presented two posters at the Fall AAFP Scientific Assembly in Denver. Dr. Bybee also recently presented his poster at the recent Graduate Medical Education event at LSU Health – Shreveport.

For the fifth consecutive year, the program filled all 6 positions in the MATCH. A record number of applications were received through ERAS. Intern orientation occurs in June and our annual Intern Welcome Event will be held in August.

An Advanced Life Support in Obstetrics course was conducted in September, 2015 for twelve residents and four Labor & Delivery nurses. The two-day course provides a five-year certification in obstetric emergencies.

We welcome 2016-2017 Chief Residents, Dr. James Moore and Dr. Lang Nolen and commend our outgoing Chief Residents, Dr. Micah Pippin and Dr. Lang Nolen, for an outstanding job during the 2015-2016 academic year.

In January, 2016 I assumed the position of Program Director. Dr. Michael Madden filled the role of Associate Program Director. The program will be relocating clinical and administrative operations soon to the main campus of Rapides Regional Medical Center. The transition will offer a larger, state of the art facility and is a wonderful growth opportunity for our program.

Respectfully submitted, Robert Moore, MD Program Director

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Baton Rouge General Medical Center Family Medicine Residency Program Program Director: Brian Harrell, MD

The 2015-2016 academic year has come to a close, and it has been a year of changes. This past year our program had to say goodbye to two beloved members of our team. Both Drs. Derek Anderson and Edward Geno left our family for other venues. Dr. Anderson currently works with Ochsner and is thankfully still very active with the LAFP, LSU Athletics and the state legislature. He also has remained active with medical education through his role within the American University of the Caribbean system. Dr. Geno has elected to continue his role in graduate medical education in Alabama. We wish them all the best for the future and look forward to any and all future interactions with them. With these changes, we have also welcomed Dr. Brian Harrell as the new Program Director. He recognizes that he walks in the strong footsteps of those who came before him and looks forward to the new challenges that lie ahead.

We are proud to announce that this graduating class has continued the trend of board passage rates greater than 90% as required by the ACGME. In fact, 100% of our graduates passed this year. On June 18th, we graduated 9 residents at the Lod Cook Alumni Center here in Baton Rouge. The name of the residents and their future plans are listed below.  Michelle Duhe, MD—Outpatient Family Medicine in Baton Rouge  Sunitha Korapati, MD—Outpatient Family Medicine in Virginia  Daniel McMahon, MD—Outpatient Family Medicine in Georgia  Bryan Picou, MD—Outpatient/Inpatient Family Medicine in Natchitoches, LA  Smita Prasad, MD—Outpatient/Inpatient Family Medicine with emphasis in Women’s Health in Franklin, LA  Zachary Pray, MD—Outpatient/Inpatient Family Medicine in Amite, LA  Clayton Runfalo, MD—Outpatient Family Medicine in Baton Rouge, LA  Shawn Skarpnes, MD—Sports Medicine Fellowship in California  Jennifer Winchester, MD—Outpatient Family Medicine in New York

Another year has begun for the interns at Baton Rouge General, and we are excited to see what this year will bring with such a great group. Our new class includes:  Stephanie Coleman, MD—LSU School of Medicine—New Orleans  Matthew Mann, MD—LSU School of Medicine—New Orleans  Janice Dara, MD—LSU School of Medicine--Shreveport  Lorene Wiley, MD—Ross University School of Medicine  Aarti Attreya, MD—University of New Mexico School of Medicine  Devin Owens, MD—LSU School of Medicine--Shreveport  Corey Lemoine, DO—William Carey University College of Osteopathic Medicine  Rachel Kermis, MD—Ross University School of Medicine

We kicked off the year with our annual Welcome Party in conjunction with our fellow Internal Medicine Residency Program Residents and faculty at a local restaurant. With the wonderful family atmosphere, it was no surprise that everyone felt at home right away as the new interns became acquainted with their new teammates. This is only the beginning of several fun gatherings throughout the year, including tailgating at LSU football games, a resident-faculty retreat, a cozy Christmas party in December, and a MATCH Party in the spring.

We are striving to give back to our community and actively participate with the state legislature. Many of our residents were very active in the recent legislative process with regard to the recent Senate Bill 187. Several of our residents and faculty participated in the LAFP Physician of the Day at the Capitol, as well as White Coat Day.

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We are looking forward to several other community events this year. Our program hosts a monthly lecture series for People’s Health, a Medicare provider that allows us an opportunity to educate our local geriatric population. Many of our residents are assisting with sports physicals at high schools and universities in the area, as well as participation in the local Tar Wars program.

Looking ahead, our program is preparing for another great year of recruiting. We are headed out to several recruitment fairs and are attracting many medical students to our program. Each year, expectations grow, and this upcoming year will be no different. We wish the best to all programs during recruiting season as we all strive to find the best Family Physicians for Louisiana.

We would also like to recognize our Sports Medicine Fellowship Program which continues to do well and which graduated their 8th class in July. This year’s graduates are Donald Carson, DO and Lacy Knowles, DO. Both have performed incredibly well this past year, and we thank them for all their hard work. Furthermore, we would like to express our excitement as Dr. Knowles will be joining us as faculty within the FMRP and Sports Medicine Program.

We extend a warm welcome to our new class of fellows: Tara Bagen, MD – Family Medicine – Louisiana State University – Shreveport Brian Williams, DO-Physical Medicine and Rehabilitation-New York University Langone Medical Center-Rusk Institute of Rehabilitation Medicine

Respectfully Submitted, Brian Harrell, MD, CAQSM Program Director

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LSUHSC - New Orleans at Bogalusa Family Medicine Residency Program Program Director: Emilio Russo, MD

The Bogalusa Rural Family Medicine Residency Program continues to strive for excellence and capitalize on the evolving healthcare landscape in south Louisiana and nationally.

There are five graduates this year, all whom passed the ABFM Board Certification Exam. Three physicians plan to stay in Louisiana, one will practice in Mississippi and one has been accepted into a sports medicine fellowship program in Alabama. • Gabriel Agbanyim, MD – Highland Community Hospital, Picayune, MS • Angela Mitchell, MD – Touro Infirmary, New Orleans, LA • Madeleine Nguyen, MD – Lane Medical Center, Zachary, LA • G. Daud Noaz, MD – Our Lady of the Angels Hospital, Bogalusa, LA • Jay Umarvadia, MD – American Sports Medicine Institute/Andrews Sports Medicine, Birmingham, AL

This year we implemented a new interview process. We offered fewer interview dates with more applicants per day. Each interviewer had specific questions and the sessions were shortened from previous years. We received excellent feedback from all of our interviewees and we successfully matched all six positions!

We are pleased to welcome six new residents to our program to begin training on July 1, 2016. The new residents are: Zack Bryant, MD, Kenneth Deaver, MD, Owen Grove, MD, Amanda Rogers, MD, Drazen Sosic, MD, and Chantel Taylor, MD. The chief residents for the new academic year are Hoangvy Le, MD and Charl Ceronio, MD.

During this academic year, we received approval from the LSU School of Medicine to offer a Global Health/International Medicine elective to our residents. We have partnered with Healing Peru, a non-profit organization dedicated to providing medical care in an Andean village in Peru. This year, two faculty members and two residents served in Andajuaylillas for two weeks. Also, in order to further develop our Global Health/International Medicine curriculum, we were able to host a guest speaker, Scott Kellermann, MD, the founder of The Kellermann Foundation. The Kellermann Foundation began with a small clinic in the Bwindi Community and now operates a one of the highest rated hospital in in Uganda, Africa. In addition, we were able to offer specialized training for physicians practicing in rural areas and presented an all-day course titled Ultrasound for Low Resource Areas. The course was very informative and offered a wide breadth of hands on experience.

Our program continues to participate in community service activities, including sports medicine physicals for the local schools, presentations to the Council on Aging and the Retired Teachers and Administrators organizations, Family Fun Fest and various health fairs in the community. We will also offer sports medicine physicals to students in the Baton Rouge area with the non-profit group 99 Wayz2Win.

Many of our faculty and residents have been busy with scholarly activity and patient safety projects. Dr. Russo, Dr. Seeliger and Dr. Mitchell presented two posters at the AAFP Global Health Conference in Denver, “From Gumbo to Cuy – Building International Academic Collaborations,” and “Developing a Global Health Track at LSU’s Rural Family Medicine Residency.” Dr. Russo, Dr. Umarvadia and Dr. Ogden were selected to present a poster at the AAFP FMX Conference titled “A Curious Case of Foot Drop.” Dr. Umarvadia, Dr. Ogden and Dr. Russo were selected to present a poster presentation at the American Medical Society for Sports Medicine (AMSSM) Annual Meeting in Dallas, TX titled, “A- Wristed Development.” Dr. Hong and Dr. Umarvadia were selected to present a poster at the 4th Annual QI/PS

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Conference in New Orleans titled “Identifying and Effectively Managing Neonatal Hypoglycemia.” Dr. Mohr has been working with the residents on an American College of Physicians initiative, “I-Raise the Rates,” which promotes vaccinations in adults.

We are excited to announce that Our Lady of the Angels Hospital will implement EPIC, a state of the art electronic medical record, in min-June. We have been working diligently as team training and preparing for this transition.

Our residency program continues to strive for excellence in medical education and patient care.

Respectfully Submitted, Emilio A. Russo, MD Program Director

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East Jefferson General Hospital Family Medicine Residency Program Affiliated with Tulane University School of Medicine Program Director: Victor Weaver, MD

The East Jefferson General Hospital Family Medicine Residency has had an exhilarating and successful year. Most of all, we wish to recognize the dedication and hard work of all our residents. Their ability to learn and grow while adapting to the unprecedented number of changes and pressures in our healthcare system is an inspiration to us all. Dr. Casey was joined by Dr. Weaver to co-lead the program as Medical Director/Associate Program Director and Program Director/DIO, respectively. Dr. O’Callaghan represented our program at the ACGME annual conference and also directed our residency’s involvement in the new SAPORO family medicine research network in southern Louisiana. Another innovative new initiative involved our hospital’s Chaplain Residency hosting our residents for shadowing sessions to learn their approaches to comforting patients and families. We have just hired our long-time friend, colleague, and teacher, OBGYN Dr. Van Culotta, a member of the Louisiana State Medical Society Physician Hall of Fame, to join us as an integrated faculty member in our residency clinic. We also continued to appreciate the strong support of our sponsoring hospital, including funding to launch an ultrasound training program for our residents in our continuity clinic. Dr. Magonet has continued to expand our integrative medicine projects and also recently traveled to Houston to M.D. Anderson for further training in building integrative medicine programs. We continued to host and teach LSU and Tulane medical students in our clinic and on our inpatient service throughout the year. Our other faculty, Drs. Cucchiara, Hulin, Russ, and Ryan continued to go above and beyond to tirelessly serve our patients, teach, and mentor our residents. Their abilities to work as hard as people in private practice, know all their patients so well, and then do all the residency teaching and mentoring duties on top of that is incredible. Susan Perrier continues to be our treasured residency coordinator who holds everything together with her endless warmth, hard work, and dedication. Since the program opened in 1998, we have graduated 92 residents. Of these, 57 are practicing in Louisiana.

On June 24, we will celebrate the graduation of six more residents at a dinner at Commander’s Palace in New Orleans. We are happy that three are staying in Louisiana. The graduates and their future practice locations are:

Megan Butler, MD Baton Rouge, LA Deanna Blanchard, MD Lafayette, LA Mitt Dave, MD Las Vegas, NV Kimi Gandhi Orlando, FL Sarah Granier, MD Metairie, LA Lauren Kendall, MD Hawaii, New Mexico or Washington

We are excited to welcome our seven new first year residents:

Charlene Chan, MD Laura Mansfield, DO Michelle Gonzaba, MD Thomas Santamaria, MD Shruti Gupta, DO Brian Templet, MD. Britta Haydel, MD

As well as Andrew Herman, MD who will be transferring to us from Pennsylvania as a second year resident.

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They join PGY-III residents: Brittany Breaux MD, Jennifer Driver MD, Jessica Gilbert MD, Ashik Lawrence MD, Sarah Schwartz MD, Ronald Slipman MD, Nathan Sutton MD and PGY – II residents: Carlie Blake, MD, Brittany Bubrig, MD, Bennett Hailey, MD, Juliette Oram, MD, Jonathon Sossamon, MD, Natalie Voithofer, MD.

Our Chief Residents for the 2016-2017academic year are Ronnie Slipman, MD, and Nathan Sutton, MD.

Respectfully Submitted, Victor Weaver, MD Program Director

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LSUHSC - New Orleans at Kenner Family Medicine Residency Program Program Director: James Campbell, MD

We welcomed a diverse group of seven new physicians to our program in July and look forward to their time of training with us:

• Matthew Alario, MD • Sadiqa Boura, MD • Penny Boyle, DO • Marco Chavez, MD • Matthew Hallowell, MD • Jessica Miller, MD • Falon Perring, MD

We would like to congratulate Dr. Adeel Zia for becoming Chief Resident for the 2016 -2017 academic year, as well as Dr. Joseph Oschwald for becoming Co-Chief Resident. We would also like to acknowledge and thank Dr. Sonia Alencherry for all of her hard work as the outgoing Chief.

It is with deep regret that we bid farewell to Michele Larzelere, PhD, who has tirelessly served our program as behavioral medicine coordinator and research coordinator since the program’s inception in 1997. She will be sorely missed but we wish her nothing but the best in her new position as at Ochsner.

Finally we said goodbye to an extraordinary class of residents at our graduation ceremony on June 19th: Sonia Alencherry, MD, Mohamad Jibawi, MD, Inayat Khan, MD, Junaid Munshi, MD, Waddah Saeed, MD, and Cesar Silva, MD. We wish our new graduates all the best in their work and future endeavors, as they serve the people of Louisiana.

Respectfully Submitted, James Campbell, MD Program Director

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LSUHSC - New Orleans at Lafayette Family Medicine Residency Program Program Director: Amanda Phillips-Savoy, MD

During this academic year (March 2016), the program had a leadership change. Dr. Kathleen Rosson, the former Program Director, will be retiring after 20 years of service to academic medicine. She mentored well-trained family physicians that serve in the local community and surrounding areas. Since 1995, she has personally educated 157 graduates of our program. Dr. Amanda Phillips-Savoy assumed the position of Interim Program Director. The program is currently seeking to hire a Program Director. Dr. Alan Broussard is the current Assistant Program Director. Our program has welcomed a new faculty member, a former graduate, Dr. Troy Guidry. The program continues to be affiliated with University Hospital and Clinics (UHC) and Lafayette General Health (LGH). While the hospital remains in a Private/Public partnership, the faculty and residents continue to be employed by LSUHSC-NO.

The program benefits the Acadiana community by providing care for a diverse population, including infants and maternity care; inpatient care at UHC and LGMC; physician volunteers at Lafayette Community Health Care Clinic; team physicians for 5 local high schools and the University of Louisiana at Lafayette; geriatric care at a local nursing home; and healthcare screenings at a variety of community-based events. The program provides telemedicine care to the CASA Aleluya orphanage in Guatemala. With the assistance of family physician and former state senator Dr. Don Hines, we perform dermatological and medical evaluations. This has been a very positive addition for the program and has been well received by the residents. We have seen over 400 pediatric patients this year.

We would like to congratulate Marc Fernandez MD and Blake McDonald MD for becoming Chief Residents for the 2016 - 2017 academic year. We would also like to acknowledge and thank Danielle Duhon MD and Shauna Bienvenu MD for all of their hard work as the outgoing Chiefs.

A record number of applicants were received through ERAS. Again, we had 8 new first year residents filled through the MATCH start their training July 1, 2016. We welcomed a diverse group of eight new physicians to our program and look forward to their time of training with us: Ravi Alagugursamy MD, Babak Amrollahie MD, Meighan Anderson MD, Danielle Fuselier MD, James Hyatt MD, Rachel Kumar MD, Alicia Ortiz MD, and Ashanti Smith MD.

Finally, we said goodbye to an extraordinary class of residents and fellows at our graduation ceremony on June 25th: Allan Olson MD, Shauna Bienvenu MD, Danielle Duhon MD, Seth Koster DO, Libby Going MD, Kevin Morris MD, Richard Pearson MD, Asma Khan MD, Kandice Deslatte MD (geriatrics fellow) and Susila Shanmuganathan MD (geriatrics fellow). They will be entering private practice, urgent care/ER, and fellowship training. The majority of the graduating residents will be practicing in the Lafayette area. One of our graduates was accepted into a Sports Medicine fellowship at Wayne State University. All third year residents successfully completed the ABFM certification examination giving our program a 100% board take and pass rate for the third consecutive year.

Our residents and faculty has been busy this year with scholarly activity. Two teams of residents took home top honors in the 2016 Annual Research Day in March. Allan Olson MD, Blake McDonald MD, Brian Allen MD, April Weliever MD, and Alex Wolf MD received the First Place Award for their poster on “Analysis of Lynch Syndrome in Cajuns”. Brian Allen MD and April Weliever MD received the Overall 1st Place Award for their presentation of “A Retrospective Analysis of the Implementation of Sepsis Quality Measures at UHC to Date.” Blake McDonald MD was awarded a scholarship for his attendance to The Obesity Summit for Residents and Fellows in Orlando, FL. Allan Olson MD participated in the creation

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of a new elective nutrition course offered for LSU Medical Students. Kandice Deslatte MD, Susila Shanmuganathan MD, and Lainie Moncada MD, geriatric fellows and staff, attended the 2016 American Geriatrics Society Annual Scientific Meeting in Long Beach, CA. They presented a poster titled “Vertebral Compression Fractures Due to Osteoporosis…Or So It was Thought.”

Our program continues to strive for excellence in medical education and patient care.

Respectfully Submitted, Amanda Phillips-Savoy, MD Program Director

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General Assembly – July 8, 2016 – Destin, FL LSUHSC - New Orleans at Lake Charles Family Medicine Residency Program Program Director: Alan LeBato, MD

It has been a very successful year in Lake Charles as we prepare to graduate 8 PGY3’s. All have taken their boards and passed. As is part of the national direction of a lot of our graduates: 1 will enter a sports medicine fellowship, 1 will enter a geriatric fellowship, 1 will enter an ER fellowship, 3 are becoming hospitalists and the final 2 will enter a traditional FM practice, one in New Iberia and the other in Lake Charles. We are fortunate to have strong ER, strong inpatient service (we are the hospitalist group for Memorial) and a strong sports medicine faculty so I can understand why some of my residents are attracted into these “lines” of FM. It is somewhat concerning though, as I look around at many of my peers who are at 30 years of private practice in rural areas, as to who is going to answer the call for rural and small town Louisiana. I, along with many of you, have fought the NP scope of practice Bill all session and I worry at some point that we won’t be available to answer the call of our patients without physician extender help.

We have attracted 8 excellent interns for the 2016-2017 year. 1 LSU-New Orleans graduate, 2 DO graduates, and 5 Canadian International Medical graduates that have rotated through Chaubert in Houma and are well trained and familiar with the system of hands on education. It appears from the match results that many of our Louisiana medical school graduates have chosen to do residencies outside of Louisiana. You have to wonder how much the “turmoil” in the Legislature with funding of healthcare and education has to do with them “choosing” spots with their feet.

I have also added another full time faculty this year as Dr. Brian Gamborg (Sulphur) has joined our other 5 full timers and now sees his private patients in our residency practice. He has been a welcome addition for his specific interest in Information Technology and is helping us design more efficient and functional templates for our day to day encounters. He also serves on the LSMS and Calcasieu Parish Medical Society boards and along with Dr. Barootes, our CPMS president this year, they are keeping the residents involved in the “politics” of medicine.

Fishing has been marginal this spring in Big Lake as we have had more rain in the past few months than we had all last year. The fresh water has pushed most self respecting salt water fish out into the Gulf of Mexico. Never the less I have continued to sneak out in the kayak or big boat just to sit on the water and hear the wind blow through my ears. It is cheaper than a visit to the psychiatrists in town. Laissez les bon temps rouler!!

Respectfully Submitted, Alan LeBato, MD Program Director

136 Family Medicine Residency Program Director Reports

General Assembly – July 8, 2016 – Destin, FL

LSUHSC - Shreveport at Monroe Family Medicine Residency Program Program Director: Eugene Luther, MD

Accreditation: We are pleased to report that have received continued accreditation from the ACGME.

Residents: We had another successful MATCH and are in the process of welcoming eight new interns to the “Conway family”. 1. We are saying goodbye to eight graduates. At least three of these graduates will be practicing in the state of Louisiana.

2. Two of our PGY 2 residents received scholarships from the Ouachita Medical Society. Congratulations to Dr. Christina Highley and Dr. Kish Carlton.

3. Dr. Narendra Kanamathareddy won 3rd place in the LSUHSC-S Department of Family Medicine poster presentation.

4. As you may have heard, the Monroe area recently had a major flood which resulted in many displaced residents and medical students. As a result, we had to scramble to arrange housing on a short notice. Since then we have an agreement to house the medical students and rotating residents in new apartments beginning July 1.

Faculty: We are pleased to announce two new faculty members to our department: Dr. Teri O’Neal and Dr. Gyanendra Sharma.

Budget: Finally, we are keeping a close eye on the budgetary process currently going on in the State Legislature. We are optimistic that the legislators will recognize the value of graduate medical education for the State of Louisiana.

Respectfully Submitted, Eugene Luther, MD Program Director

137

Family Medicine Residency Program Director Reports

General Assembly – July 8, 2016 – Destin, FL

LSUHSC - Shreveport/Vivian Family Medicine Residency Program Program Director: Luke Baudoin, MD

The Shreveport family medicine residency programs continue to be strong in Northwest Louisiana. Since the start of our program in 1977, there have been 264 Shreveport/Vivian residency graduates and 3 EM/FM graduates. Of these, 170 are practicing in Louisiana and 44 are practicing in Louisiana rural areas (less than 10,000 population). This year we are graduating six residents from the traditional program, three from the rural program, and two from the EM/FM program. Their new practice plans include:  Joszi Aldridge, MD (EM/FM) – Our Lady of the Lake Hospital, Baton Rouge, LA  Jeremy Hawkins, MD (EM/FM) – Princeton Baptist Medical Center, Birmingham, AL  Rosie Singh, MD (Rural) – Dawson Family Physicians, Dawson, GA  Mary Eskander, MD (Rural) – Decision Pending  Danielle Raley, MD (Rural) – Willis Knighton, Bossier City, LA  Tara Bagen, MD – Sports Med Fellowship – Baton Rouge, LA  Erin Breard, MD – Ouachita Family Doctors, Monroe, LA  Ashtaad Dalal, MD – Sleep Medicine Fellowship – Shreveport, LA  Nadia Gomes, MD – Christus Health, Shreveport, LA  Raj Makadia, MD – Sunny Slope Family Clinic, Phoenix, AZ  Ike Nwanwkwo, MD – Decision Pending

We are very pleased with the interns we matched in all three tracks this year. Our incoming residents this year include:  Lindsey Tassin, MD (Rural) o Undergraduate: Millsap’s College o Medical School: LSUHSC Shreveport  LaTashia Irving, MD (Rural) o Undergraduate: Duke University o Medical School: University of Texas Medical Branch School of Medicine  Sylvia Maniscalco, MD (Rural) o Undergraduate: University of Windsor o Medical School: Avalon University  Hernando Aro, MD (EM/FM) o Undergraduate: University of Texas at Arlington o Medical School: Rodd University  Ayesha Tabassom, MD (EM/FM) o Undergraduate: Kennesaw State University o Medical School: Mercer University

138

Family Medicine Residency Program Director Reports, continued

General Assembly – July 8, 2016 – Destin, FL

 Jaclyn Chhangur, MD (Core) o Undergraduate: The University of Western Ontario o Medical School: Medical University of the Americas  Nikki Chopra, MD (Core) o Undergraduate: American International College of Arts and Sciences o Medical School: American University of Antigua  Sandeep Grewal, MD (Core) o Undergraduate: McMaster University o Medical School: University of Medicine and Health Sciences, St. Kitts  Ali Nazari, MD (Core) o Undergraduate: University of Calgary o Medical School: Medical University of the Americas  Daniel Piotter, MD (Core) o Undergraduate: San Francisco State University o Medical School: Ross University  John Yager, MD (Core) o Undergraduate: University of Colorado o Medical School: Ross University

Dr. Tammy Baudoin (APD), Dr. Luke Baudoin (PD), and Kelsey Gender (Residency Coordinator) attended the AAFP PDW/RPS workshops this year. We have upgraded our didactics and hope to continue to improve our residency education.

Respectfully submitted, Luke Baudoin M.D. Program Director, Family Medicine

139

Foundation President’s Report

General Assembly – July 8, 2016 – Destin, FL

LAFP Foundation Report Melvin Bourgeois, MD

(1) I would like to first, thank the Foundation Board of Directors for all of their support and participation over the past year. We essentially exist as a charitable and educational vehicle with status as a non-profit tax deductible organization to contract with government entities and to receive philanthropic gifts.

(2) The following are the members of the 2015-2016 Board of Directors:

Executive Committee: President Melvin Bourgeois, MD President-Elect Brian Elkins, MD Past President Mike Harper, MD Executive Director Ragan LeBlanc Secretary Wayne Gravois, MD Treasurer Bryan Picou, MD

Members: Justin Angelle Jonathan Hunter, MD Kenny Laborde Barry Dunn Ed Martin, MD Nadine Robin Kim Gassie Al Rees, MD

(3) The LAFP Foundation relies heavily on membership support for continuance of Foundation supported programs within the Academy. Because of generous donors, the LAFP Foundation was able to provide continued support to an array of programs and awards throughout the year. We had 2015 revenues of $23,601.75. We had expenses of $32,165.63 for an operating deficit of $8,563.88. Most of our expenses are Grand Rounds and programs/awards for students and residents. Currently, the operating account for the Foundation has $52,285.84.

(4) The LAFP savings account has $3139.65 which is the interest bearing account for the two CD accounts for the Gerald R. Gehringer and Michael Fleming award funds. Currently the Gehringer fund has $14,470.00, the Fleming Fund has $10,000 and the Tulane fund has $3,950.00.

(5) The Foundation has received a $40,000 donation from Ochsner Health Systems to fund the Grand Rounds for The Greater New Orleans Area Grand Rounds and the Baton Rouge Area Grand Rounds. In June 2016, the first Baton Rouge Area Grand Rounds was held at Ruffino’s. Faculty and residents from the Baton Rouge General Residency Program presented, ¡Los Medicos en Nicaragua!. The Foundation will continue to operate as a vehicle for contracting with the State and as a repository for funds which donors may wish to provide to support educational or charitable projects. The LAFP Foundation selected Brian J. (Jake) Johnson for the Family Medicine Student Externship Program. Mr. Johnson is a second year medical student at LSU Health-New Orleans. Dr. Albert Kerr, LAFP member from Rayville, LA, served as his preceptor for the 4-week summer rotation. Mr. Johnson As part of the externship program, Mr. Johnson will be conducted a research program on diabetes that looks at predictors of difficulty with glycemic control.

(6) We are fortunate to Katie Underwood join the LAFP staff as Foundation Coordinator.

140

Foundation President’s Report, continued

General Assembly – July 8, 2016 – Destin, FL

Awards (1) Congratulations to following 2015 Family Medicine Awards Recipients: The Gerald R. Gehringer, MD, Family Medicine Award was awarded to Danielle Fuselier. The Tulane Family Medicine Excellence Award was awarded to Nicole “Nikki” Gentile. The Michael O. Fleming, MD, Family Medicine Award was awarded to Janice Dara. The Resident Award of Excellence was awarded to Micah Pippin, MD.

(2) The Foundation participated in the 2016 AAFP National Conference of Family Medicine Students and Residents. A resident and student delegate was chosen from the LAFP resident and student membership to represent Louisiana during the resident and student congresses, held in conjunction with National Conference. The Louisiana Resident Delegate is Ronald Slipman, MD – Kenner Family Medicine Residency Program and the Student Delegate is Khine Sein - Tulane University School of Medicine.

(3) The LAFP Foundation was awarded $5,000 from the AAFP Family Medicine Philanthropic Consortium (FMPC) to support a conference in Fall 2016 titled LAFP 101. This one day event will offer an agenda center around leadership development in an effort to increase the understanding of membership benefits and governance/leadership opportunities available to our membership

(4) The 2015 Foundation Auction held in New Orleans raised $12,243.00 for the Foundation. We appreciate all of the auction items donated by our Board and LAFP members as well as the hard work of our LAFP staff in preparing for the auction each year. We hope the auction this year in New Orleans will be as successful! The 2016 Foundation Auction will be held on the evening of Friday, July 8. All meeting attendees and their families are invited to attend; we hope to see everyone there!

(5) Finally, let me thank all of you who have donated to the Foundation this year. It is with these donations that we are able to continue our mission and programs. If you have not donated, allow me to take this time to ask you to strongly consider a gift to the Foundation before the end of the year. Remember no money….no mission….so please give generously!

Respectfully Submitted, Melvin Bourgeois, MD LAFP Foundation President

141 2016 Family Medicine Awards

General Assembly – July 8, 2016 – Destin, FL

LSU-Shreveport Michael O. Fleming, MD Award

The Michael O. Fleming MD Family Medicine Award was presented to Janice Dara. Ms. Dara is a 2012 graduate of Louisiana State University Agricultural and Mechanical College, Baton Rouge, LA where she earned a Bachelors of Science in Biological Sciences. Ms. Dara was actively involved in community service even before starting medical school in July 2012. Her desire to serve patients with limited access to medical care has been a primary driver in her pursuit of her medical career. She has participated in the Global Health elective in Kenya with Support for Humanism through Intercontinental Projects. Ms. Dara has also actively supported medical student initiatives through the Family Medicine Interest Group, the Neurology Interest Group, Shreveport Rescue Mission Child Care, the American Medical Association, and Camp Tiger. She leads the local chapter of the Student National Medical Association as Creative Director. Ms. Dara will complete her residency in Family Medicine at the Baton Rouge General Family Medicine Residency Program.

LSU-New Orleans Gerald R. Gehringer Family Medicine Award

LSU-New Orleans Gerald R. Gehringer Family Medicine Award was presented to Danielle Fuselier. She is a 2012 graduate of Louisiana State University Agricultural and Mechanical College, Baton Rouge, LA where she earned a Bachelors of Science in Biological Sciences. Ms. Fuselier has held the leadership positions in the Family Medicine Interest Group by serving a president and vice-president of the Rural Medicine Interest Group at LSU Health- New Orleans. She has volunteered as an Acadian Ambulance Stretcher Bearer and a counselor with Camp Tiger. Her hobbies include cooking, traveling, bowling, hunting & fishing. Ms. Fuselier will complete her residency in Family Medicine at the Family Medicine Residency Program at University Hospitals and Clinics-Lafayette.

Tulane Family Medicine Excellence Award

The Tulane Family Medicine Excellence Award was presented to Nicole “Nikki” Gentile at the annual Tulane Ivy Day Awards Ceremony. Ms. Gentile is a 2012 graduate of University of California, Davis where she earned a Ph.D. in Comparative Pathology/Integrative Pathobiology. She also holds a Bachelors of Science in Neurobiology, Physiology and Behavior from University of California, Davis. Ms. Gentile has been actively involved in the Family Medicine Interest Group at Tulane School of Medicine by serving as secretary. She was also selected as the student representative to the Editorial Advisory Board for the Annals of Family Medicine. Ms. Gentile will complete her residency in Family Medicine at the University of Washington.

142 2016 Family Medicine Awards, continued

General Assembly – July 8, 2016 – Destin, FL

Resident Award of Excellence Award

The Resident Award of Excellence was presented to Micah Pippin, MD. Dr. Pippin is a graduate of Tulane School of Medicine and the Family Medicine Residency Program- Alexandria where he served as Chief Resident. He excelled in his residency program having been selected by faculty, residents and staff to receive the 2015 Outstanding Resident Award from the program as a second year resident. Along with being Chief Resident, he has also supervised the didactic lecture series for the other residents and has volunteered his time to mentoring medical students and teaching suture workshops. His desire to teach and share his knowledge is reflected in the fact that he will join the faculty here at Family Medicine Residency in Alexandria in July 2016.

143 LaFamPac Board Report

General Assembly – July 8, 2016 – Destin, FL

LaFamPac Board Report Marguerite “Cissy” Picou, MD

(1) The PAC Board voting members for 2015 were:

President Marguerite Picou, MD Treasurer Wayne Gravois, MD District 1 Rep. James Campbell, MD District 2 Rep. Dan Jens, MD District 3A Rep. Jack Heidenreich, MD District 3B Rep. Zeb Stearns, MD District 4 Rep. Russell Roberts, MD District 5 Rep. Tahir Qayyum, MD District 6A Rep. James Taylor, MD District 6B Rep. Chris Foret, MD District 7 Rep. Jody George, MD District 8 Rep. Bryan Picou, MD

PAC Donation by LAFP Members (2) We thank our LAFP members who continue to strengthen our advocacy by donating to the PAC. Between July 1, 2015 and July 1, 2016 LaFamPac has collected $10,814.00 in donations from 27 members of the Louisiana Academy of Family Physicians (LAFP). The average donation was $400. We encourage all of the members at the General Assembly to consider stopping by the registration desk to discuss our advocacy in action initiatives as well as make a minimum contribution to the PAC.

(3) To date, the Board has made the following contributions in 2015. Name Amount Katrina Jackson Campaign Fund 2,500.00 Keith DeSonier Campaign Fund 500.00 Malinda White Campaign Fund 500.00 Dalton Honore Campaign Fund 1,000.00 Beth Mizell Campaign Fund 1,000.00 Lenar Whitney Campaign Fund 500.00 Franklin Foil Campaign Fund 500.00 Terrence Vinson Campaign Fund 500.00 Paula Davis Campaign Fund 750.00 Robert Carter Campaign Fund 250.00 Richard T. Burford Campaign Fund 500.00 House Democratic Campaign Committee of LA 1,000.00 Beth Mizell Campaign Fund 1,000.00 Richard T. Burford Campaign Fund 1,000.00 Lenar Whitney Campaign Fund 500.00 Paula Davis Campaign Fund 750.00 Robert Carter Campaign Fund 750.00 Ray Garofalo Campaign Fund 250.00 Julie Emerson Campaign Fund 500.00 144 LaFamPac Board Report, continued

General Assembly – July 8, 2016 – Destin, FL

JBE Transition Team LLC 1,500.00 Total 15,750.00

LaFamPac continues to direct contributions to those candidates who serve on key committees, who hold positions of leadership, or who have supported LAFP’s key legislative priorities through bill co-sponsorship or votes in favor of LAFP-supported legislation. LaFamPac also targets contributions to senators and representatives who are elected from the districts of LAFP Board of Directors, members of the LaFamPac Board of Directors, and members of the Legislative and Membership Issues Committee. This strategy will enhance the contacts between these LAFP leaders and their state legislators. However, there are some districts that, even though they have a significant number of PAC contributors, will not have legislators who meet the eligibility criteria for contributions. Nonetheless, the value of member donations to the PAC is to enhance legislative advocacy statewide.

(4) I encourage all members and especially those of you designated leaders of the General Assembly to take less than five minutes and open up your wallet to donate to the LAFP State PAC.

Respectfully Submitted, Marguerite “Cissy” Picou, MD President - LaFamPac

145

BYLAWS (Revised as of 2015 General Assembly)

PAGE 1 146 TABLE OF CONTENTS THE LAFP

Chapter I Name 3 Chapter II Affiliation 3 Chapter III Objects and Purposes 3 Chapter IV Memberhsip 3 Chapter V Dues and Assessments 9 Chapter VI Meetings 10 Chapter VII General Assembly 10 Chapter VIII Officers 11 Chapter IX Board of Directors 12 Chapter X Duties of Officers and Directors 14 Chapter XI Nominations and Election of Officers and Directors 17 Chapter XII Executive Committee 18 Chapter XIII Component and Student Chapters 18 Chapter XIV Standing Committees 20 Chapter XV Ethics 22 Chapter XVI Inspection of Records 23 Chapter XVII Parliamentary Authority 23 Chapter XVIII Indemnification 24 Chapter XIX Amendment of Bylaws 25 1

PAGE 2 147 1 Chapter I 2 Name 3 4 The name of this organization, an association of Family Physicians, incorporated under the laws of the 5 State of Louisiana, shall be the Louisiana Chapter of the American Academy of Family Physicians. 6 7 CHAPTER II 8 Affiliation 9 10 This organization is a constituent chapter of the American Academy of Family Physicians, a corporation 11 existing under the laws of Louisiana, and is possessed only of those rights and powers conferred by said 12 corporation to this organization. No rules, regulations, or policies adopted by this organization shall be 13 in conflict with the rules, regulations or policies of the American Academy of Family Physicians or the 14 charter issued by said Academy to this organization. 15 16 The autonomy of the LAFP is limited by the Bylaws of the American Academy. Membership in the LAFP 17 shall be a prerequisite to membership in the American Academy, but the qualifications for membership 18 are established by the American Academy. 19 20 CHAPTER III 21 Objects and Purposes 22 23 SECTION 1. Purposes. To the end that the people of Louisiana may receive excellence in health care, 24 LAFP has for its purposes the following: 25 (1) To promote and maintain high standards among physicians who practice family medicine; 26 (2) To provide responsible advocacy for and education of patients and the public in all health related 27 matters; 28 (3) To preserve and promote quality cost effective health care; 29 (4) To promote and maintain the science and art of family medicine and to ensure an optimal supply 30 of well-trained family physicians; 31 (5) To preserve the right of family physicians to engage in medical and surgical procedures for which 32 they are qualified by training and experience; 33 (6) To provide for the continuing professional development of its members; 34 (7) To provide advocacy, representation and leadership for the specialty of family medicine; and 35 (8) To maintain and provide an organization with high standards to fulfill the above purposes and to 36 represent the needs of its members. 37 38 SECTION 2. Objects. This organization shall have no capital stock. It is not conducted for pecuniary 39 profit and does not contemplate pecuniary gain or profit to the members thereof. 40 41 CHAPTER IV 42 Membership 43 44 SECTION 1. Definition. Family Physicians. For the purpose of these Bylaws, family physicians are defined 45 as physicians in the discipline of family medicine whose training and experience qualify them to practice 46 in several fields of medicine and surgery, with particular emphasis on the family unit. 47

PAGE 3 148 1 SECTION 2. Classification. There shall be the following classes of members: (A) active; (B) inactive; (C) 2 life; (D) honorary; (E) resident; (F) student; (G) supporting; and (H) international. 3 A. Active Members. 4 1. Eligibility. Active members shall be family physicians: 5 a. duly licensed to practice medicine 6 (1) in the state of Louisiana or 7 (2) that are actively working in locum tenens in a United States federal facility, provided 8 that such physician is duly licensed to practice medicine by the state medical board; 9 or 10 (3) in a position that does not require a medical license in the jurisdiction where 11 working, provided that such physician is duly licensed to practice medicicine by the 12 state medical board and that shuch physician’s practice complies with all applicable 13 state licensing requirements; and 14 b. who have completed a family medicine residency program approved by the 15 Accreditation Council on Graduate Medical Education (ACGME); or 16 (1) have completed a family medicine residency program approved by the College of 17 Family Physicians of Canada, and be board certified by the College of Family 18 Physicians of Canada and be employed exclusively within the United States; or 19 (2) be board certified by the American Board of Family Medicine pursuant to a 20 reciprocity agreement between the American Board of Family Medicine and a 21 foreign professional association of family medicine or general practice; or 22 (3) have satisfactorily completed either: 23 (a) one year of a rotating general or family medicine internship approved by the 24 American Osteopathic Association (AOA) plus two years of a general or family 25 medicine residency program approved by the American Osteopathic 26 Association; or 27 (b) three years of a general or family medicine residency program approved by the 28 American Osteopathic Association; or 29 c. previously held active membership before December 31, 1988; or 30 d. those family physicians duly licensed and residency trained who practice in a state, 31 province, or territory where no constituent chapter exists and who have been elected by 32 the Board of Directors, hereinafter referred to as the Board, pursuant to the rules and 33 procedures of the AAFP. 34 2. Application and Approval. Application for membership shall be made on a form prescribed 35 by the American Academy of Family Physicians. Election to membership shall be by the 36 approval of the Executive Vice President, followed by the publication of the applicant’s 37 name in the LAFP newsletter. 38 3. Requirements. 39 a. Election to active membership shall be for a maximum period of three (3) years, at the 40 expiration of which term the member shall be eligible for re-election. No member shall 41 be re-elected to membership who is not in good standing at the time of their re-election 42 and has not fulfilled the continuing medical education requirements. 43 b. Former active members who apply for membership less than two years after having 44 ceased to be an active member must provide evidence they have earned the requisite 45 100 credits of continuing medical education acceptable to the Board; except that such 46 an applicant who was a resident member in good standing and automatically upgraded 47 to active status upon completion of residency training but never paid dues as an active

PAGE 4 149 1 member shall not be required to satisfy this continuing medical education requirement 2 upon reapplication within two years of completion of residency training. 3 c. Active members must have graduated from an accredited school of medicine or 4 osteopathy. 5 4. Privileges. Active members shall have all privileges of membership that includes one vote 6 and the privilege of the floor during the General Assembly meeting, entitled to hold office in 7 the LAFP and have a voice in standing committees. 8 B. Inactive Members. 9 1. Eligibility. Effective January 1, 1989, inactive members shall be members who are: 10 a. incapacitated by reason of illness, accident, or infirmity or; 11 b. totally retired with less than twenty (20) years continued membership in the AAFP; or 12 c. under extenuating circumstances established by the Board, active members, resident 13 members and family physician supporting members who interrupt their practices or 14 residency training; provided, however, that no person may hold inactive membership 15 who does not hold a current medical license because such license has been revoked as a 16 result of a disciplinary action. 17 2. Application and Approval. Application for membership shall be made on a form prescribed 18 by the American Academy of Family Physicians. Election to membership shall be by the 19 approval of the Executive Vice President, followed by the publication of the applicant’s 20 name in the LAFP newsletter. 21 a. Election to inactive membership shall be for a maximum of one year, subject to re- 22 election pursuant to clause c below, unless the member is totally retired. 23 b. An inactive member may be re-elected to this classification annually by the Board. 24 c. Totally retired members need not be re-elected annually. 25 d. Inactive members shall not be required to meet the continuing medical education 26 requirements as provided in Section 3 of this Chapter. 27 3. Privileges. Inactive members shall be given privileges of the floor of the General Assembly 28 without the right to vote, not be entitled to hold office in the LAFP and not have a voice in 29 standing committees . 30 31 C . Life Members. 32 1. Eligibility. Life members shall be persons who have continued membership in the AAFP for a 33 minimum of 20 years and who have attained age seventy (70) or who are totally retired 34 from the practice of medicine. No person may hold life membership who does not hold a 35 current medical license because such license has been revoked as a result of a disciplinary 36 action. 37 2. Application and Approval. Requests for life membership shall be made to the Executive Vice 38 President for approval, followed by the publication of the applicant’s name in the LAFP 39 newsletter. 40 3. Requirements. Life members are relieved of the continuing medical education requirements 41 as provided in Section 3 of this Chapter. 42 4. Privileges. Life members shall be given privileges of the floor of the General Assembly 43 without the right to vote, not be entitled to hold office in the LAFP and have a voice in 44 standing committees. 45 46 47

PAGE 5 150 1 D. Honorary Members. 2 1. Eligibility. Honorary members shall be persons of distinction who have rendered outstanding 3 service to the LAFP or to the medical profession, or distinguished members of the LAFP who 4 have retired from practice. 5 2. Nomination and Approval. Nominees for honorary membership must be presented to the 6 Board for consideration. 7 3. Privileges. Honorary members shall not pay dues or admission fees, and shall have no right, 8 title or interest in any of the property of the LAFP, may not hold office but shall be given 9 privileges of the floor of the General Assembly without the right to vote and have a voice in 10 standing committees. 11 12 E. Resident Members. 13 1. Eligibility. Resident members shall be: 14 a. physicians in training in: 15 (1) an ACGME-approved family medicine residency; or 16 (2) an AOA-approved rotating general or family medicine internship; or 17 (3) an AOA approved general or family medicine residency; or 18 b. graduates of ACGME-approved family medicine residencies; or AOA-approved general 19 or family medicine residencies who extend their training immediately upon completion 20 of residency training and who serve full time in extended, structured, supervised 21 programs of at least one year duration to gain additional skills in research, 22 administration and teaching or a specific clinical area of interest. 23 2. Application and Approval. Applications for resident membership shall be made in writing on 24 a form prescribed by the American Academy of Family Physicians. Election to membership 25 shall be by approval of the Executive Vice President, followed by publication of the 26 applicant’s name int the LAFP newsletter. 27 a. Election to resident membership shall be for the duration of one’s residency or 28 extended training. 29 b. Upon completion of their residency training, and upon verification of eligibility for active 30 membership, resident members shall be automatically transferred to active 31 membership. 32 3. Privileges. 33 a. Resident members may serve on committees as determined by the Board. Resident 34 members who are appointed to serve on committees have the right to vote in such 35 bodies but are not eligible to serve as chair. 36 b. A resident member shall be elected to serve on the Board of Directors as described in 37 Chapter IX of these Bylaws. 38 c. The resident member of the Board shall have full voting privileges on the Board. 39 d. A resident member shall be elected to serve as the resident delegate to the General 40 Assembly, who shall have full voting privileges in the General Assembly. 41 e. A resident member shall be elected to serve as the resident delegate to the AAFP 42 National Conference. 43 f. Otherwise, resident members shall not be entitled to hold office in the LAFP, but shall 44 have voice in standing committees. 45 46 47 48

PAGE 6 151 1 F. Student Members. 2 1. Eligibility. Student members shall be students enrolled in accredited schools of medicine or 3 osteopathy. Membership shall terminate upon graduation or withdrawal from medical 4 school. 5 2. Application and Approval. Applications for resident membership shall be made in writing on 6 a form prescribed by the American Academy of Family Physicians. Election to membership 7 shall be by approval of the Executive Vice President, followed by publication of the 8 applicant’s name int the LAFP newsletter. 9 3. Requirements. Students applying for student membership must be enrolled in a school of 10 medicine or osteopathy approved by an appropriate United States accrediting institution as 11 defined by the AAFP Commission on Education. 12 4. Privileges. 13 a. Student members may serve on committees as determined by the Board. Student 14 members who are appointed to serve on committees have the right to vote in such 15 bodies but are not eligible to serve as chair. 16 b. A student member shall be elected to serve on the Board as described in Chapter IX of 17 these Bylaws. 18 c. The student member of the Board shall have full voting privileges on the Board. 19 d. A student member shall be elected to serve as the student delegate to the General 20 Assembly, who shall have full voting privileges in the General Assembly. 21 e. A student member shall be elected to serve as the student delegate to the AAFP 22 National Conference. 23 f. Otherwise, student members shall not be entitled to hold office in the LAFP but shall 24 have a voice in standing committees. 25 26 G. Supporting Members. 27 1. Eligibility. 28 a. Supporting members shall be: 29 (1) physicians in specialties other than family medicine and not otherwise eligible for 30 some other category of membership; or 31 (2) physicians actively engaged in family medicine, the teaching of family medicine or 32 medical administration for the previous six years, but who do not qualify for 33 active membership because they have not completed the necessary residency 34 training; and 35 b. Duly licensed in the state in which he or she practices. 36 2. Application and Approval. Application for membership shall be made on a form prescribed 37 by the American Academy of Family Physicians. Election to membership shall be by 38 approval of the Executive Vice President, followed by publication of the applicant’s name in 39 the LAFP newsletter. 40 3. Requirements. 41 a. Supporting members must earn 150 credits of acceptable continuing medical education 42 every three years in order to retain supporting membership, except that supporting 43 members actively engaged in a specialty other than family medicine shall be relieved of 44 the continuing medical education requirements. 45 b. Supporting members who are eligible by virtue of being actively engaged in family 46 medicine, the teaching of family medicine or medical administration for the previous six 47 years must have earned 100 credits of continuing medical education acceptable to the 48 Board of Directors during the two years immediately preceding their application for

PAGE 7 152 1 supporting membership only if they previously held supporting membership and ceased 2 to be a supporting member less than two years prior to reapplying for supporting 3 membership. 4 4. Privileges. Supporting Members shall be given privileges of the floor of the General 5 Assembly without the right to vote, not be entitled to hold office in the LAFP and have a 6 voice in standing committees . 7 8 H. International Members. 9 1. Eligibility. International members shall be: 10 a. family physicians outside of the United States engaged in family medicine, the teaching 11 of family medicine or medical administration, who are licensed to practice in countries 12 or territories outside the United States in which no constituent chapter exists and who 13 are not eligible for membership in the Uniformed Services chapter; or 14 b. medical students and physicians in training in countries or territories outside the United 15 States in which no constituent chapter exists and who are not eligible for membership in 16 the Uniformed Services chapter; or 17 c. a graduate of a medical school located outside of the United States who: 18 (1) was an international member as a student at that school; and 19 (2) has completed all pre-residency requirements for, but has not yet entered, an 20 ACGME-approved family medicine residency or an AOA-approved general or family 21 medicine residency, may extend his/her international membership through the 22 period ending December 31st of the second calendar year following the calendar 23 year in which such student graduates, without regard to his/her country of 24 residency during such extended period. 25 (3) If such graduate has not successfully entered an approved family medicine residency 26 program by the end of the extended period as described above, he/she will no 27 longer qualify for membership and the AAFP shall cause such member’s name to be 28 dropped from the membership roll. 29 2. Application and Approval. Applications for international membership shall be made on a 30 form prescribed by the American Academy of Family Physicians. Election to membership 31 shall by by the approval of the Executive Vice President, followed by publication of the 32 applicant’s name in the LAFP newsletter. 33 3. Requirements. International members shall be relieved of the continuing medical education 34 requirements as provided in Section 3 of this Chapter. 35 4. Privileges. International members shall be given privileges of the floor of the General 36 Assembly without the right to vote, not be entitled to hold office in the LAFP and have a 37 voice in standing committees . 38 39 SECTION 3. Good Standing. A member in good standing shall be one whose current dues and 40 assessments, if any, have been paid in accordance with the provision of these Bylaws, who is duly 41 licensed to practice medicine, and who has met the applicable CME requirements during the period of 42 the preceding three (3) years as set forth in these Bylaws and the Bylaws of the AAFP. 43 44 A member who is on probation or has limitations/restrictions on his/her license but is still able to 45 practice medicine according to the Louisiana state licensing board is considered a member in good 46 standing. 47 48

PAGE 8 153 1 SECTION 4. Changes in Membership Status. Any member who changes his or her occupation or status 2 in such a manner as to render him or her ineligible for membership in the LAFP, may, unless he or she 3 resigns, be dropped from the roll of members by the Board. The Board or an entity designated by the 4 Board, acting in accordance with Board approved criteria, may waive or reduce members’ dues. Other 5 exceptions to the foregoing membership rules and requirements may be made under unusual 6 circumstances and on an individual basis only upon a two-thirds (2/3) vote of the Board. 7 8 SECTION 5. Acceptance of Membership. Acceptance of membership in the LAFP shall constitute an 9 agreement by such member to comply with the Bylaws thereof and to recognize the Board as the sole 10 and only judge of the right to remain a member. 11 12 All rights, title, and interest, both legal and equitable, of a member in and to the property of the LAFP 13 shall cease and terminate in the event of the any of the following: (a) the expulsion of such member; (b) 14 the striking of his/her name from the roll of members; or (c) his/her death or resignation. 15 16 SECTION 6. Transfer of Membership. The transfer of membership from the LAFP to another state 17 chapter shall be subject to the approval of the AAFP Board of Directors. 18 A. Transfer of membership shall: 19 1. Occur within six (6) months after moving; 20 2. Be verified for eligibility of membership in the LAFP of the new practice location or 21 residence; and 22 3. Provide notice of transfer to the member and to the previous and new chapters. 23 B. Members who fail to transfer their LAFP membership within six (6) months, shall, upon 24 verification of eligibility, be automatically relocated to the chapter in which they then 25 practice or reside. If membership eligibility cannot be verified in the new chapter where the 26 member practice or resides, then the member shall be notified that after thirty (30) days 27 their membership will be canceled. 28 C. If transferring to a a state or region where no constituent chapter exists, a member shall 29 remain a member of his/her constituent chapter. 30 D. Resident members shall automatically be transferred who have just completed their 31 residency training and are relocating to the appropriate chapter without first being required 32 to apply for transfer of membership in that chapter. 33 34 CHAPTER V 35 Dues and Assessments 36 37 SECTION 1. Active Members. Dues for active members shall be set by the General Assembly as 38 recommended by the Board of Directors. Dues are due and payable upon election to membership and 39 shall be payable in advance on the first day of January of each year. 40 41 SECTION 2. Service Members. The dues of other than active members shall be fixed by the Board of 42 Directors. In addition, other than active members shall be required to pay such dues to the American 43 Academy of Family Physicians as may be prescribed by the Bylaws of that organization. Under unusual 44 circumstances and on an individual basis, the Board of Directors by a two-thirds (2/3) vote may waive 45 payment of dues upon recommendation of the constituent chapter and with the approval of the AAFP 46 Board of Directors. 47

PAGE 9 154 1 SECTION 3. Special Assessments. Special assessments not to exceed one hundred dollars ($100.00) may 2 be applied equally to all members by affirmative action of two thirds (2/3) of the members of the 3 General Assembly. Notification of a proposal to vote on an assessment must be in writing at least 100 4 days prior to the meeting of the General Assembly. 5 6 SECTION 4. Any member whose dues or assessments are unpaid at the time of any annual meeting shall 7 be ineligible to vote or to hold office. 8 9 CHAPTER VI 10 Meetings 11 12 SECTION 1. Annual Meeting. Unless otherwise ordered by the Board of Directors there shall be an 13 annual meeting of the LAFP which shall include a meeting of the General Assembly together with such 14 meetings of the Board of Directors, Executive Committee, and other standing committees as may be 15 fixed by the Board of Directors. The date and place of the annual meeting shall be designated by the 16 Board of Directors. 17 18 SECTION 2. General Assembly. The General Assembly shall meet during the annual meeting of the LAFP 19 and at such other times and places as it may determine. Special meetings may be called by the Board of 20 Directors or the President. Special meetings shall be called by the Secretary upon the written request of 21 any ten (10) or more members at a place and time determined by the Board of Directors. Special 22 meetings shall be held at such time and place as may be set forth in said call, provided notice of such 23 meeting dates shall be given by the Executive Vice President in writing at least sixty (60) days prior. The 24 Board of Directors may adopt such rules of procedure for the transaction of business at the annual 25 meeting, General Assembly, or any special meeting of the LAFP as it deems desirable unless otherwise 26 provided in these Bylaws. 27 28 CHAPTER VII 29 General Assembly 30 31 SECTION 1. Definition. The control and administration of the LAFP shall be vested in the General 32 Assembly, subject to the statutory authority of the Board and to those additional duties and powers 33 specifically reserved to the Board in these Bylaws. The General Assembly may, at any time by a majority 34 vote, refer and submit to the members of the LAFP defined questions affecting the policy or 35 recommendations of the LAFP which, in the opinion of the General Assembly, are of immediate, 36 practical consequence to the members of the LAFP and to the public. The result of the referendum 37 when duly ascertained by such vote shall control the acts of the LAFP and its officers, agents and 38 employees. 39 40 SECTION 2 Notice. Notice of the General Assembly shall be given by the Secretary to all members at 41 least sixty (60) days prior to the date of such meeting, either by letter mailed to the member's address 42 as it appears on the Secretary's records or by publications in the official publication, if any, of the LAFP. 43 44 SECTION 3. The Executive Vice President of the LAFP shall be the Secretary of the General Assembly. 45 46 SECTION 4. Composition. The composition of the General Assembly shall be: 47 E. Any LAFP member in good standing

PAGE 10 155 1 F. One medical student and one resident shall be elected for a term of one year to serve as 2 delegates, each of whom shall be student or resident members, respectively, and in good 3 standing 4 5 SECTION 5. Election. The process for election of the student and resident delegate shall be in 6 accordance with these Bylaws. 7 8 SECTION 6. Privileges. Privileges of the floor and the right to vote and hold office in each class of 9 membership shall be the same as provided in that class of membership located in Chapter IV of these 10 Bylaws. 11 A. Any active member shall have one vote and have the privilege of the floor in the General 12 Assembly. 13 B. Privileges of the floor without the right to vote shall be granted to all other classifications of 14 membership as specified in these Bylaws. 15 C. Adopt such rules of procedure for the transaction of its business as it deems desirable. 16 17 SECTION 7. Resolutions. 18 A. Except as provided in paragraph B of this Section 7, resolutions shall be submitted in writing to 19 the Executive Vice President or the Speaker of the General Assembly at least thirty (30) days prior 20 to the meeting at which they are to be acted upon. Any resolution not meeting the 30 day 21 deadline is considered late. 22 B. Late resolutions pertinent to the objectives of the LAFP may be submitted in writing as follows: 23 (1) any LAFP member may submit a late resolution up to one hour before the opening of the 24 General Assembly. 25 C. An affirmative vote of two-thirds (2/3) of the members of the General Assembly present and 26 voting shall be required for consideration of each such late resolution. 27 28 SECTION 8. Quorum. Twenty-five (25) voting members shall constitute a quorum for the transaction of 29 business during the General Assembly, and unless otherwise provided in these Bylaws, the articles of 30 incorporation or by law, all matters shall be determined by a majority vote of the members present and 31 voting. There shall also be one student and one resident member elected by the student and resident 32 members. The resident and student member shall have full voting privileges in the General Assembly. 33 34 CHAPTER VIII 35 Officers 36 37 SECTION 1. Officers. The elected officers of the LAFP shall be a President, President-Elect, Vice 38 President, Treasurer, Secretary, Speaker of the General Assembly, and Vice-Speaker of the General 39 Assembly. The Executive Vice President need not, be a member and will serve as an an ex officio 40 member of the Board without vote appointed by the Board. 41 42 SECTION 2. AAFP Delegates and Alternate Delegates. There shall be two (2) Delegates and two (2) 43 Alternate Delegates elected to the Congress of Delegates of the American Academy of Family Physicians. 44 45 SECTION 3. The Board of Directors shall elect a Treasurer from among the members of the LAFP for a 46 term and stipend, if any, to be determined by the Board. 47

PAGE 11 156 1 SECTION 4. Terms of Office. All officers elected shall take office immediately following the General 2 Assembly meeting at which they are elected. 3 A. President. The term of office begins at the conclusion of his/her term as president-elect and 4 expires at the conclusion of the next annual meeting of the General Assembly, or when his/her 5 successor is seated. 6 B. President- Elect. The term of office begins at the conclusion of the annual meeting of the 7 General Assembly at which his/her election occurred and shall expire upon succeeding to the 8 office of president. 9 C. Vice President. The term of office begins at the conclusion of the annual meeting of the General 10 Assembly at which elected and expires at the conclusion of the next annual meeting of the 11 General Assembly, or when his/her successor is seated. 12 D. Secretary. The term of office begins at the conclusion of the annual meeting of the General 13 Assembly at which elected and expires at the conclusion of the next annual meeting of the 14 General Assembly, or when his/her successor is seated. 15 E. Speaker and Vice Speaker of the General Assemly. The term of office begins at the conclusion of 16 the annual meeting of the General Assembly at which elected and expires at the conclusion of 17 the next annual meeting of the General Assembly, or when his/her successor is seated. 18 19 SECTION 5. Vacancies. 20 A. President. If a vacancy exists in the office of President due to death, resignation, or for any 21 reason the President shall be unable or unqualified to serve, the President-Elect shall succeed to 22 the office of President for the unexpired portion of the President’s term. In the event of the 23 death, resignation , or incapacity of both the President and the President Elect, the Vice- 24 President shall succeed to the office of the President for the unexpired portion of the 25 President’s term. 26 B. Vice President, Secretary, Speaker/Vice Speaker and AAFP Delegates/Alternates. Vacancies for 27 the office of President-Elect, Vice-President, Treasurer, Secretary, and AAFP Delegates and 28 Alternates shall be filled by appointment by the Board of Directors, provided however, that such 29 appointment shall terminate at the next annual meeting of the General Assembly at which time 30 the nominating committee shall present a nominee for the unexpired term, if any. 31 32 CHAPTER IX 33 Board of Directors 34 35 SECTION 1. Composition. Subject to the action of the General Assembly, and during the interim 36 between the meetings of the General Assembly, the control and administration of the LAFP shall be 37 vested in a Board of Directors composed of the following: 38 A. President; 39 B. President-Elect; 40 C. Immediate Past President 41 D. Vice President; 42 E. Secretary; 43 F. Treasurer; 44 G. Speaker of the General Assembly; 45 H. Vice-Speaker of the General Assembly; 46 I. Two (2) AAFP Delegates (or Alternate Delegates); and

PAGE 12 157 1 J. One (1) member (Director or Alternate Director) from each of the ten (10) geographic districts, 2 the at large membership, the resident membership, the student membership and the Executive 3 Vice President. 4 5 SECTION 2. Executive Vice President. The Executive Vice President will serve as an officer of the LAFP in 6 a non-voting capacity. 7 8 SECTION 3. Eligibility and Term of Board of Directors. 9 A. All members of the Board of Directors shall be members in good standing at the time of their 10 election and throughout their term of office. 11 B. All Directors, except those from the resident and student membership, shall be elected for 12 terms of office of two (2) years with such terms to expire at the conclusion of the second 13 succeeding meeting thereafter. 14 C. Resident and Student Directors shall be elected for one (1) year with such terms to expire at the 15 conclusion of the first succeeding meeting thereafter. 16 D. In the absence of an elected Director his/her alternate can be seated with voting privileges. 17 E. Elections for Alternate Directors are handled in the same manner as Directors. 18 F. No Director or Alternate Director shall be elected to no more than four (4) consecutive two (2) 19 year terms before a mandatory year or more absence. 20 G. All elected members of the Board of Directors shall take office immediately following the annual 21 General Assembly meeting at which they were elected. 22 H. Any Director who absences himself/herself from three (3) successive stated meetings of the 23 Board of Directors without a reasonable excuse acceptable to the Board of Directors shall be 24 considered as having resigned from the Board. 25 26 27 SECTION 4. Eligibility and Term of AAFP Delegates and Alternate Delegates. 28 A. Initially, one (1) Delegate and one (1) Alternate shall be elected for a term of two (2) years. 29 B. Thereafter, both Alternates and both Delegates shall be elected for terms of two years which 30 shall begin at the conclusion of the annual meeting at which their election occurs and expire at 31 the conclusion of the second succeeding annual meeting. 32 C. The Delegates or their Alternates shall be voting members of the LAFP Board of Directors. 33 D. No Delegate or Alternate Delegate shall be elected to no more than four (4) consecutive two (2) 34 year terms before a mandatory year or more absence. 35 36 SECTION 5. Unless otherwise specifically provided, the Board of Directors shall fill all vacancies which 37 occur among Officers, Board members, Delegates and Alternate Delegates. Vacancies so filled shall be 38 filled for the unexpired portion of the term. 39 40 SECTION 6. The Board of Directors shall hold two (2) meetings annually in addition to those held in 41 conjunction with the annual assembly. 42 43 SECTION 7. The majority of the Board shall constitute a quorum for the transaction of any business and 44 unless provided otherwise in these Bylaws, the articles of incorporation or by law, all matters shall be 45 decided by a majority vote of the Directors present and voting. 46

PAGE 13 158 1 CHAPTER X 2 Duties of Officers and Board of Directors 3 4 SECTION 1. President. The duties of the President shall include the following: 5 1. Preside at all general meetings of the LAFP; 6 2. Serve as the Chair of the Board of Directors; 7 3. Preside at all meetings of the Board of Directors; 8 4. Preside at all meetings of the Executive Committee of the Board of Directors; 9 5. Serve as ex-officio member of all standing committees; 10 6. Appoint all committees of the LAFP with approval of the Board of Directors; 11 7. Appoint a Nominating Committee with himself/herself as a member at least ninety (90) days 12 before the General Assembly; 13 8. Deliver an annual report to the General Assembly; 14 9. Represent the entire membership and the best interest of the LAFP; 15 10. Represent the Family Physicians of the State of Louisiana before the public, the Louisiana State 16 Medical Society, the medical schools, and the peers of other medical specialties; 17 11. Preside over meetings of the General Assembly in the absence of the Speaker and the Vice 18 Speaker; and 19 12. Perform such other duties as may be required of him/her by law, custom, parliamentary usage, 20 or other rules of the LAFP. 21 22 SECTION 2. President-Elect. The duties of the President-elect shall include the following: 23 1. Assume the office of the President at the end of his/her term as President-elect; 24 2. Serve as a member of the Board of Directors; 25 3. Serve as a member of the Executive Committee of the Board of Directors; 26 4. Preside at all meetings of the Board in the absence of the President and the Vice President; 27 5. Perform such other duties as may be required of him/her by the President or the Board of 28 Directors; and 29 6. Perform such other duties as may be required of him/her by law, custom, parliamentary usage, 30 or other rules of the LAFP. 31 32 SECTION 3. The Vice-President. The duties of the Vice President shall include the following: 33 1. Serve as a member of the Board of Directors; 34 2. Serve as a member of the Executive Committee of the Board of Directors; 35 3. Officiate at meetings of the Board of Directors in the absence of the President; 36 4. Know the management of the LAFP and be supportive of the aims and objectives of the 37 President; 38 5. Update the Policy Manual as needed during even years (beginning in 1992); 39 6. Serve on selected committees as appointed by the President; 40 7. Serve as the Master of Ceremonies at the Awards and Installation Luncheon/Banquet; 41 8. Perform such other duties as may be required of him/her by the President, the Board of 42 Directors and the membership of the General Assembly; and 43 9. Perform such other duties as may be required of him/her by law, custom, parliamentary usage, 44 or other rules of the LAFP. 45 46 SECTION 4. Secretary. The duties of the Secretary shall include the following: 47 1. Serve as a member of the Board of Directors; 48 2. Serve as a member of the Executive Committee of the Board of Directors;

PAGE 14 159 1 3. Serve as a member on the Committee on Legislative and Membership Issues and Committee on 2 Operations; 3 4. Be responsible for the activities of the Headquarters Office as directed by the General Assembly 4 and the Board of Directors; 5 5. Serve as the Master of Ceremonies during the Awards and Installation Luncheon/Banquet in the 6 event that the Vice-President is unable; 7 6. Supervise preparation of the official minutes of all meetings of the Board of Directors, Executive 8 Committee and General Assembly; 9 7. Deliver and prepare a written report for all Board Meetings and the annual General Assembly; 10 8. Perform such other duties as may be required of him/her by the President, the Board of 11 Directors and the membership of the General Assembly ; and 12 9. Perform such other duties as may be required of him/her by law, custom, parliamentary usage, 13 or other rules of the LAFP. 14 15 SECTION 5. Treasurer. The duties of the Treasurer shall include the following: 16 1. Serve as a member of the Board of Directors; 17 2. Serve as a member of the Executive Committee of the Board of Directors; 18 3. Be elected for a term and stipend, if any, to be fixed by the Board; 19 4. Serve as Chair of the Committee on Operations; 20 5. Keep adequate and proper account of the properties and funds of the LAFP; 21 6. Deposit or cause to be deposited all monies and other valuables in the name and to the credit of 22 the LAFP with such depositories as may be designated by the Board of Directors; 23 7. Disburse the funds of the LAFP as may be ordered by the Board of Directors; 24 8. Give, whenever the Board of Directors may request it, an account of all his/her transactions as 25 Treasurer, and of the financial condition of the LAFP; 26 9. Give a surety bond, if any, in an amount to be determined by the Board of Directors, the 27 premium thereon to be paid by the LAFP; 28 10. Have such other powers and perform such other duties as may be prescribed by the Board of 29 Directors or the LAFP's Bylaws; and 30 11. Perform any of the duties of the Treasurer may, by action of the Board of Directors, be assigned 31 to the Executive Vice President 32 33 SECTION 6. Immediate Past President. The duties of the Immediate Past Presient shall include the 34 following: 35 1. Serve as a member of the Board of Directors; 36 2. Serve as a member of the Executive Committee of the Board of Directors; 37 3. Serve as a member on the Committee on Operations; 38 4. Review incomplete projects for evaluation by the Board of Directors to determine if they should 39 be continued, abandoned, or altered; 40 5. Conduct the annual evaluation of the Executive Vice President; 41 6. Perform such other duties as may be required of him/her by the President, the Board of 42 Directors and the membership of the General Assembly ; and 43 7. Perform such other duties as may be required of him/her by law, custom, parliamentary usage, 44 or other rules of the LAFP. 45 46 SECTION 7. Speaker of the General Assembly. The duties of the Speaker of the Generaly Assembly shall 47 include the following: 48 1. Serve as a member of the Board of Directors;

PAGE 15 160 1 2. Serve as a member of the Committee on Operations; 2 3. Preside over all meetings of the General Assembly; 3 4. Address the General Assembly at the opening session of all meetings, limiting his/her address to 4 matters of conduct and procedure in the Assembly; 5 5. Perform such other duties as may be required of him/her by the President, the Board of 6 Directors and the membership of the General Assembly ; and 7 6. Perform such other duties as may be required of him/her by law, custom, parliamentary usage, 8 or other rules of the LAFP. 9 10 SECTION 8: Vice Speaker of the General Assembly. The duties of the Vice Speaker of the General 11 Assembly shall include the following: 12 1. Serve as a member of the Board of Directors; 13 2. Serve as a member of the Committee on Operations; 14 3. Officiate for the Speaker during his/her absence or at his request at the General Assembly; 15 4. Perform such other duties as may be required of him/her by the President, the Board of 16 Directors and the membership of the General Assembly ; and 17 5. Perform such other duties as may be required of him/her by law, custom, parliamentary usage, 18 or other rules of the LAFP. 19 20 SECTION 9. Executive Vice President. The Executive Vice President shall be appointed for a term and 21 stipend to be fixed by the Board of Directors. The duties of the Executive Vice President shall include the 22 following: 23 1. Perform such duties as the office ordinarily connotes and such duties of the Treasurer as may be 24 assigned by the Board of Directors. 25 2. Keep or cause to be kept an accurate record of the minutes of and transactions of the General 26 Assembly and the Board of Directors and shall serve as Secretary of these bodies. 27 3. Supervise all other employees and agents of the LAFP and have such other powers and duties as 28 may be described by the Board of Directors or these Bylaws. 29 4. Not be entitled to vote, unless he/she is a member of the LAFP. 30 5. Be bonded in an amount fixed by the Board of Directors, the premium thereon to be paid by the 31 LAFP. 32 33 SECTION 10. Directors. The duties of the Directors shall include the following: 34 1. Serve as a member of the Board of Directors; 35 2. Act as the advisor to the physicians in his/her district; 36 3. Submit at the General Assembly a written report of the activities during the preceding year; 37 4. Perform such other duties as may be required of him/her by the President, the Board of 38 Directors and the membership of the General Assembly ; and 39 5. Perform such other duties as may be required of him/her by law, custom, parliamentary usage, 40 or other rules of the LAFP. 41 42 SECTION 11. Alternate Directors. The duties of the Alternate Directors shall include the following: 43 1. Serve as a member of the Board of Directors; 44 2. Act as the advisor to the physicians in his/her district in the absence of the Director or 45 membership category; 46 3. Perform such other duties as may be required of him/her by the President, the Board of 47 Directors and the membership of the General Assembly ; and

PAGE 16 161 1 4. Perform such other duties as may be required of him/her by law, custom, parliamentary usage, 2 or other rules of the LAFP. 3 4 SECTION 12. AAFP Delegates and Alternate Delegates. The two (2) Delegates and two (2) Alternates to 5 the Congress of Delegates of the American Academy of Family Physicians shall: 6 1. Represent the LAFP at all meetings of said Congress of Delegates. 7 8 CHAPTER XI 9 Nominations and Election of Officers and Board of Directors 10 11 SECTION 1. Nominations. All candidates for LAFP elected office including President-Elect, Vice President, 12 Secretary, Treasurer, Speaker, and Vice-Speaker of the General Assembly, and for each vacancy 13 occurring on the Board of Directors shall be nominated. The letter of endorsement/ nomination shall be 14 submitted in writing to the Executive Vice President. 15 16 SECTION 2. Nominations Committee. At least ninety (90) days prior to the General Assembly it shall be 17 the duty of the President to appoint a nominating committee consisting of himself/herself, the 18 immediate Past President, the President-Elect and two members of the Board of Directors. The 19 nominating committee shall present to the General Assembly, at its annual meeting, nominations for 20 each position of Director and Alternate Director which shall become vacant at that annual meeting; 21 provided, however, that nothing herein contained shall be construed as preventing nominations from 22 the floor. No person may be nominated for the position of Director or Alternate Director who does not 23 reside or practice in the geographic district which that position represents on the Board of Directors, 24 except for the at large, resident and student membership positions. 25 26 SECTION 3. At the time of the annual meeting, the nominating committee shall present nominations to 27 the General Assembly for the offices of President-Elect, Vice President, Secretary, Speaker, Vice-Speaker 28 and one (1) Delegate and one (1) Alternate Delegate to the Congress of Delegates of the American 29 Academy of Family Physicians and any vacant Director and Alternate Director position. Additional 30 nominations for these offices may be made from the floor of the Assembly. 31 32 SECTION 4. Elections. 33 A. Officers. 34 (1) The General Assembly shall elect annually a President-Elect, Vice President, Secretary, 35 Speaker, and Vice Speaker. 36 (2) Election of the above officers shall be by ballot prepared by the Executive Vice President, 37 except that unopposed candidates may be elected by voice vote. The candidate receiving 38 the majority of votes cast for each office shall be declared elected. 39 B. Board of Directors. 40 (1) The General Assembly shall elect annually one member for each vacancy occurring on the 41 Board of Directors. 42 (2) Election of the above officers shall be by ballot prepared by the Executive Vice President, 43 except that unopposed candidates may be elected by voice vote. The candidate receiving 44 the majority of votes cast for each office shall be declared elected. 45 C. Resident Member of the Board of Directors. 46 (1) The resident member shall be elected in accordance with the guidelines approved by the 47 Board.

PAGE 17 162 1 (2) The resident member, who is elected annually, shall have his/her name and credentials 2 presented for approval by the General Assembly. 3 D. Student Member of the Board of Directors. 4 (1) The student member shall be elected in accordance with the guidelines approved by the 5 Board. 6 (2) The student member, who is elected annually, shall have his/her name and credentials 7 presented for approval by the General Assembly. 8 E. AAFP Delegates and Alternate Delegates. 9 (1) The General Assembly shall elect annually one member for each vacancy occurring on the 10 Board of Directors. 11 (2) Election of the above officers shall be by ballot prepared by the Executive Vice President, 12 except that unopposed candidates may be elected by voice vote. The candidate receiving 13 the majority of votes cast for each office shall be declared elected. 14 15 CHAPTER XII 16 Executive Committee 17 18 SECTION 1. Composition. The Executive Committee shall be composed of six members as follows: 19 A. the President; 20 B. the President-Elect; 21 C. the Vice President; 22 D. the Secretary; 23 E. the Treasurer, and 24 F. the Immediate Past President 25 26 SECTION 2. Duties and Powers. The Executive Committee, by a majority vote, shall have full authority to 27 conduct necessary business: 28 A. that demands prompt action in the interim between meetings of the Board; or 29 B. when it is impracticable or impossible to convene the Board of Directors; or 30 C. when the Board authorizes or otherwise directs the Executive Committee to act for and on 31 behalf of the Board. 32 33 SECTION 3. Meetings. Meetings of the Executive Committee shall be held at the call of the President. 34 35 SECTION 4. Quorum. Three members of the Executive Committee shall constitute a quorum for any 36 regular or special meeting of the Executive Committee. 37 38 SECTION 5. Reports. The Executive Committee shall provide a written report of its activities to the Board 39 since the last Board meeting. 40 41 CHAPTER XIII 42 Component and Student Chapters 43 44 SECTION 1. Upon the petition of any five (5) or more members of this constituent chapter, the Board of 45 Directors may issue a charter for a component or student chapter of the LAFP, provided, however, that 46 no more than one component chapter shall be chartered for a designated geographical region within 47 this state and such geographical region may, but need not, be the same as the geographical state

PAGE 18 163 1 districts established pursuant to Chapter IX, Section 1. Such chapters shall be in such form as approved 2 from time to time by the Board of Directors. 3 4 SECTION 2. Said petition shall be accompanied by the proposed Bylaws for the component or student 5 chapter. No charter shall be issued until such Bylaws are approved by the Board of Directors. 6 7 SECTION 3. The members of a component chapter shall be the persons to whom a charter is issued and 8 such additional persons meeting the qualifications for membership set forth in these Bylaws and the 9 Bylaws of the American Academy of Family Physicians. Such members shall practice within the 10 geographical boundaries of the component chapter as designated by the Board of Directors provided, 11 however, that and upon written request of the member he/she may affiliate with another component 12 chapter at the discretion of the Board of Directors. No person may hold membership in a component 13 branch unless he/she be likewise a member of this constituent state chapter and the American Academy 14 of Family Physicians. 15 16 SECTION 4. The members of a student chapter shall be medical or osteopathic students to whom a 17 charter is issued and such additional persons meeting the qualifications for student membership set 18 forth in these Bylaws and the Bylaws of the American Academy of Family Physicians. Such members 19 shall attend school within the geographic boundaries of the student chapter as determined by the Board 20 of Directors provided, however, that under usual circumstances and upon written request of the 21 member he/she may affiliate with another component chapter at the direction of the Board of 22 Directors. No person may hold membership in a student chapter unless he/she is likewise a student 23 member of this constituent state chapter and the American Academy of Family Physicians. 24 25 SECTION 5. The charter of any component or student chapter may be suspended or revoked by the 26 Board of Directors in the event of any action deemed to be in conflict with the letter or intent of these 27 Bylaws or of the lawful requirements of the Board of Directors or officers of the LAFP, in the manner 28 hereinafter specified. 29 30 Any member of the LAFP may file written charges against any such component or student chapter with 31 the Secretary of this chapter. Such charges must be signed by the accuser or accusers, and must state 32 the acts or conduct complained of with reasonable particularity. The Secretary must present said 33 charges to the Board of Directors at its next meeting. The Board of Directors shall then or at any 34 adjournment of said meeting, but not more than thirty (30) days thereafter, consider the charges and 35 shall either dismiss them or proceed as hereinafter set forth. 36 37 If the Board fails to dismiss said charges it shall within ten (10) days thereafter cause a copy of the 38 charges to be served upon the accused component or student chapter by depositing in the United States 39 mail a copy thereof, registered and mailed to the Secretary or other officer of said chapter. The Board 40 shall also and at the same meeting fix a time and place for the hearing of said charges and the accused 41 component or student chapter shall be notified of the time and place at the same time and in the same 42 manner as provided for the serving of the charges. The time set for the hearing shall be not less than 43 fifteen (15) days nor more than ninety (90) days after service of charges. 44 45 The Board shall, after having given the accused and the accuser reasonable opportunity to be heard in 46 person or by counsel and to present all evidence and proofs, conclude the hearing and within thirty (30) 47 days thereafter shall render a decision. The affirmative vote of a majority of the members of the Board 48 present and voting shall constitute the decision of said Board which may by such vote dismiss the

PAGE 19 164 1 charges or order them presented to a regular or special meeting of the members of the Louisiana 2 Chapter. In either event the Board shall make known its decision in a written resolution signed by the 3 Secretary and chair thereof. In the former event the Board shall furnish the accused and the accuser 4 with a copy of the resolution. In the latter event its resolution shall be read at the next regular meeting 5 of the members or at a special meeting duly called for that purpose, provided that a copy of the decision 6 shall be delivered to the accused in the same manner provided for the service of charges at least fifteen 7 (15) days before such meeting. The accused and the accusers shall be given reasonable opportunity to 8 be heard at the meeting of the members where the decision is read. A two-thirds (2/3) majority of all 9 those present and voting shall be required to suspend or revoke the charter of the accused component 10 chapter. 11 12 CHAPTER XIV 13 Standing Committees 14 15 The committees of the LAFP shall be standing committees. All members of any LAFP committee must be 16 a member of the LAFP. 17 SECTION 1. Regular Standing Committees Listing. The following standing committees shall be 18 established by the President with the advice and concurrence of the Board of Directors: 19 (1) Committee on Education; 20 (2) Committee on Operations; 21 (3) Committee on Legislative & Membership Issues; 22 (4) Nominating Committee 23 (5) Resident and Student Leadership Committee 24 25 The composition of these bodies shall be determined by the Board of Directors and their functions shall 26 be as specifically set forth in other sections of these Bylaws and as may be determined by the Board of 27 Directors. 28 29 SECTION 2. Organization. The President, with the advice of the Board of Directors, may appoint such 30 additional committees or similar organizational entities to assist the Board of Directors as he deems 31 appropriate. The composition and functions of such additional committees or organizational entities 32 shall be as determined by the Board of Directors. 33 34 SECTION 3. Committee on Education. The functions of this committee shall be: 35 (1) To plan and conduct the scientific program at the Annual Scientific Assembly. 36 (2) To encourage and assist members in conducting research appropriate to the field of Family 37 Medicine. 38 (3) To conduct, develop, assist and evaluate educational programs developed for the education and 39 training of Family Physicians at the graduate and undergraduate level, and developed to provide 40 continuing medical education for the benefit of the members of the LAFP and of the profession 41 at large. 42 43 SECTION 4. Committee on Operations. The Treasurer of the LAFP shall serve as Chair of the Committee 44 on Operations. The functions of this committee shall be: 45 (1) To supervise the financial transactions of the LAFP including, but not limited to: 46 (a) submitting an annual budget for the approval of the Board of Directors, 47 (b) supervising the keeping of the LAFP’s accounts,

PAGE 20 165 1 (c) supervising the operational costs and approving all expenditures incurred in maintaining the 2 LAFP Headquarters Office Building including all property. 3 (2) To bienally make a study of the Bylaws and make recommendations for changes, deletions, or 4 modifications in order to maintain the integrity and consistency of the Bylaws. 5 (3) To evaluate LAFP projects and recommend to the Board of Directors any initiative which would 6 aid in the Long Range Planning of the LAFP. 7 8 SECTION 5. Committee on Legislative & Membership Issues. The functions of this committee shall be: 9 (1) To promote membership interest in the LAFP. 10 (2) To initiate, coordinate, and subsidize membership services made available through the LAFP. 11 (3) To evaluate and advise the Board of Directors on issues of concern to minority physicians. 12 (4) To evaluate and advise the Board of Directors on issues of concern to women in medicine. 13 (5) To evaluate and advise the Board of Directors on issues of concern to new physicians in practice. 14 (6) To evaluate and advise the Board of Directors on other issues as deemed appropriate by the 15 Board of Directors. 16 (7) To formulate and advise the Board of Directors on plans and programs which expand, maintain 17 and improve health care services and standards. 18 (8) To investigate and recommend such action to the Board of Directors to insure that the Louisiana 19 Chapter of the AAFP shall have an active voice on all issues concerning legislative and 20 governmental affairs. 21 (9) To recommend to the Board of Directors such campaigns of public enlightenment or education 22 as it may deem appropriate. 23 (10) To evaluate such issues of ethics as may come before the LAFP and to make recommendations 24 to the Board of Directors on such ethical issues as the Board shall deem appropriate. 25 (11) To evaluate and advise the Board of Directors on the special health care needs of minority 26 population groups. 27 28 SECTION 6. Committee on Nominations. The President shall, at least ninety days before the General 29 Assembly meeting, form the Nominating Committee, which will be comprised for the following 30 members: the Legislative and Membership Committee Chair, who will serve as the Nominating 31 Committee Chair, the President, President-Elect, Immediate Past President and two other Board of 32 Directors members selected by the President. 33 34 The functions of this committee shall be: 35 (1) meet at least ninety days prior to the date of the annual General Assembly. 36 (2) insure that there is at least one candidate for election to each officer position; and each vacant 37 Director and Alternate Director slot; and each vacant AAFP Delegate and AAFP Alternate 38 Delegate slot. 39 (3) investigate the qualifications of prospective candidates and receive assurance from each 40 selectee that he/she is willing and eager to serve the LAFP and attend all Board Meetings and 41 other meetings that the position requires. 42 (4) present the selections of the Nominating Committee, with the exception of the Office of 43 Treasurer, at a time during the General Assembly determined by the Speaker. These 44 nominations, as presented by the Committee Chair, shall indicate that the selections are not 45 endorsements and other nominations from the Assembly floor are in order. 46 (5) present a nomination for the Office of Treasurer to the Board of Directors meeting held during 47 the Assembly. 48

PAGE 21 166 1 SECTION 7. Resident and Student Leadership Committee. The functions of this committee shall be: 2 (1) To provide a forum for resident and student members of the LAFP to meet and discuss problems 3 and solutions regarding Family Medicine policy, primary care physician recruitment, clinical skills 4 assessment and improvement, and leadership development. 5 (2) To support, encourage, and validate the choice of Family Medicine as a specialty. 6 (3) To coordinate efforts in recruitment and programming between residents and students in the 7 state 8 (4) To evaluate and advise the Board of Directors on issues unique to medical students and family 9 medicine residents 10 (5) To facilitate the LAFP Mentorship Program amongst students, residents, and practicing 11 physicians 12 (6) To facilitate planning of resident and student programs, 13 (7) To assist in planning resident and student activities at Annual Assembly, and 14 (8) To promote LAFP information and events to residency programs and FMIGs 15 16 SECTION 8. Meetings. 17 Each Committee, excluding the Committee on Nominations, shall meet at least twice a year and submit 18 an annual report to the Board of Directors prior to the annual meeting of the General Assembly. 19 20 CHAPTER XV 21 Ethics 22 23 SECTION 1. Definition. The Principles of Medical Ethics of the American Academy of Family Physicians, 24 as they now or hereafter may provide, shall be the principles of ethics of the LAFP and shall be and 25 hereby are made a part of these Bylaws. 26 27 SECTION 2. Charges. If any member is believed in good faith to: 28 A. Have violated the Principles of Medical Ethics or the Bylaws of the LAFP and/or of the American 29 Academy of Family Physicians, or 30 B. Be otherwise guilty of conduct justifying censure, suspension, or expulsion from the LAFP, any 31 member may prefer charges against him/her in the form and manner hereinafter specified. 32 (1) Charges must be in writing and signed by the accuser or accusers 33 (2) Charges must state the acts or conduct complained of with reasonable particularity. 34 (3) Charges must be filed with the Secretary 35 (4) At the first meeting of the Board held after the filing of said charges, the Secretary must 36 present said charges to the Board. 37 (5) The Board shall then or, at any adjournment of said meeting but not more than thirty (30) 38 days thereafter, consider the charges and shall either dismiss them or shall proceed as 39 hereinafter set forth, provided, however, that to the extent the provisions in this chapter 40 are in conflict with applicable law, the provisions of applicable law shall supersede these 41 Bylaws. 42 (6) If the Board fails to dismiss said charges it shall: 43 a. within fifteen (15) days thereafter cause a copy of the charges to be served upon the 44 accused by depositing in the United States mail a copy thereof, registered and 45 addressed to the last known address of the accused; 46 b. at the same meetings, fix a time and place for hearing said charges; 47 c. notify the accused of the time and place for hearing said charges and in the same 48 manner as provided for the serving of the charges; and

PAGE 22 167 1 d. time set for said hearing shall be not less than fifteen (15) days nor more than six 2 months after serving of charges. 3 (7) The accused may answer in writing but need not do so and failure to answer shall not be an 4 admission of truth of the charges or a waiver of the accused's right to a hearing. 5 (8) The Board shall: 6 a. after having given to the accuser and the accused every opportunity to be heard, 7 including oral arguments and the filing and consideration of any written briefs, 8 conclude the hearing; and 9 b. within thirty (30) days thereafter shall render a decision. 10 (9) The affirmative vote of a majority of the members of the Board present and voting shall 11 constitute the verdict of said Board which by such vote may exonerate, censure, suspend or 12 expel the accused member. 13 (10) The decisions of the Board shall be signed only by the President and the Secretary. 14 (11) Only Board members who are present for the entire hearing may vote. 15 16 SECTION 3. Censure. Censure shall mean a reprimand by the chair of the Board of Directors 17 administered to the accused in the presence of the said Board. No member shall be suspended for more 18 than one (1) year and at the expiration of the period of suspension shall be reinstated to membership 19 upon his/her application and the payment of dues accrued during the period of suspension. 20 Any member who has been censured, suspended, or expelled may appeal such action to the American 21 Academy of Family Physicians pursuant to the Bylaws of said corporation. 22 23 CHAPTER XVI 24 Inspection of Records 25 26 SECTION 1. Inspection of Records. The minutes of the proceedings of the Board of Directors, the 27 membership books, and the books of account shall be open to inspection upon the written demand of 28 any member at any reasonable time, for any purpose reasonably related to the members interest as a 29 member, and shall be produced at any time when requested by the demand of ten percent (10%) of the 30 members at any regular or special meeting of the members. Such inspection may be made by agent or 31 attorney, and shall include the right to make extracts thereof. Demand of inspection, other than a 32 meeting of the members, shall be in writing, upon the President or Secretary of the Louisiana Chapter. 33 34 SECTION 2. Fiscal Year. The fiscal year of the LAFP shall begin on the first day of January and end on the 35 last day of December of each year. 36 37 CHAPTER XVII 38 Parliamentary Authority 39 40 SECTION 1. Parliamentary Procedure. In the absence of any provision in the Bylaws, all meetings of the 41 LAFP and of the Board of Directors shall be governed by the parliamentary rules and usage’s contained 42 in the most current edition of American Institute of Parliamentarians Standard Code of Parliamentary 43 Procedure, revised. 44

PAGE 23 168 1 CHAPTER XVIII 2 Indemnification 3 4 SECTION 1. The LAFP may indemnify any person who was or is a party or is threatened to be made a 5 party to any action, suit or proceeding, whether civil, criminal, administrative or investigative (including 6 any action by or in the right of the LAFP) by reason of the fact that such person is or was a Director, 7 Officer, employee or agent of the LAFP, or is or was serving at the request of the LAFP as a Director, 8 Officer, employee or agent of another business, foreign or non-profit corporation, partnership, joint 9 venture or other enterprise, against expenses (including attorneys' fees), judgments, fines and amounts 10 paid in settlement actually and reasonably incurred by him/her in connection with such action, suit 11 proceeding if he/she acted in good faith and in a manner he/she reasonably believed to be in or not 12 opposed to the best interests of the LAFP, and with respect to any criminal action or proceeding, had no 13 reasonable cause to believe his/her conduct was unlawful; provided that in case of actions by or in the 14 right of the LAFP, the indemnity shall be limited to expenses (including attorney's fees and amounts paid 15 in settlement not exceeding, in the judgment of the Board of Directors, the estimated expense of 16 litigating the action to conclusion) actually and reasonably incurred in connection with the defense or 17 settlement of such action and no indemnification shall be made in respect of any claim, issue or matter 18 as to which such person shall have been adjudged after to be liable for negligence or misconduct in the 19 performance of his/her duty to the LAFP unless and only to the extent that the court shall determine 20 upon application, that despite the adjudication of liability but in view of all the circumstances of the 21 case, he/she is fairly and reasonably entitled to indemnity for such expenses which the court shall deem 22 proper. The termination of any action, suit or proceeding by judgment, order, settlement, conviction, or 23 upon a plea of nolo contendere or its equivalent, shall not, of itself, create a presumption that the 24 person did not act in good faith and in a manner which he/she reasonably believed to be in or not 25 opposed to the best interests of the LAFP and ,with respect to any criminal action or proceeding, had 26 reasonable cause to believe that his/her conduct was unlawful. 27 28 SECTION 2. Successful Defense. To the extent that a Director, Officer, employee or agent of the LAFP 29 has been successful on the merits or otherwise in defense of any such action suit or proceeding, or in 30 defense of any claim, issue or matter therein, he/she shall be indemnified against expenses (including 31 attorneys' fees) actually and reasonably incurred by him/her in connection therewith. 32 33 SECTION 3. Standard of Conduct. The indemnification hereunder (unless ordered by the court) shall be 34 made by the LAFP only as authorized in a specific case upon a determination that applicable standard of 35 conduct has been met. Such determination shall be made (1) by the Board of Directors by a majority 36 vote of a quorum consisting of Directors who were not parties to such action, suit or proceeding, or (2) if 37 such a quorum is not obtainable or a quorum of disinterested Directors so directs, by independent legal 38 counsel, or (3) by the Members. 39 40 SECTION 4. Advance Payment. The expenses incurred in defending such an action, suit or proceeding 41 may be paid by the LAFP in advance of the final disposition thereof if authorized by the Board of 42 Directors, as provided above, upon receipt of an undertaking by or on behalf of the Director, Officer, 43 employee or agent to repay such amount if it shall ultimately be determined that he/she is not entitled 44 to be indemnified by the LAFP as authorized. 45 46 SECTION 5. Other Rights. The indemnification provided hereunder shall not be deemed exclusive of any 47 other rights to which one indemnified may be entitled under any bylaw, agreement, authorization of 48 members or Directors, regardless of whether Directors authorizing such indemnification are

PAGE 24 169 1 beneficiaries thereof, or otherwise, both as to action in his/her official capacity and as to action in 2 another capacity while holding such office, and shall continue as to a person who has ceased to be a 3 Director, Officer, employee or agent and shall inure to the benefit of his/her heirs and legal 4 representative. 5 6 SECTION 6. Insurance. The LAFP shall have the power to procure insurance or other similar arrangement 7 including, without limitation, a trust fund or other form of self-insurance, on behalf of any person who is 8 or was a Director, Officer, employee, or agent of the LAFP, or is or was serving at the request of the LAFP 9 as Director, Officer, employee or agent of another business, non-profit or foreign corporation, 10 partnership, joint venture or other enterprise against any liability asserted against or incurred by 11 him/her in any such capacity, or arising out of his/her status as such, whether or not the LAFP would 12 have the power to indemnify him/her against such liability under the Non-Profit Corporation Law of 13 Louisiana. 14 15 CHAPTER XIX 16 Bylaws or Amendments 17 18 SECTION 1. Bylaws or Amendents. 19 1. Any five (5) or more members may propose Bylaws or Amendments of Bylaws. 20 2. Such proposals shall be submitted to the Executive Vice President or the Secretary at least sixty 21 (60) days prior to any regular or special meeting of the General Assembly and notice shall be 22 given by him/her to all members at least thirty (30) days prior to the meeting at which the 23 proposals are to be voted upon. 24 3. Such notice shall: 25 a . be published in an official publication of the LAFP sent to the entire membership; and 26 b. include a summary of all proposed amendments; and 27 c . set forth a mechanism by which any member may obtain a copy of all proposed 28 amendments. 29 4. An affirmative vote of at least two-thirds (2/3) of the members present and voting shall 30 constitute adoption. 31 5. Amendments shall take effect immediately upon adoption unless otherwise specified.

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