About Beth Collis

Dinsmore attorneys guide Ohio health care organizations and physicians through transactional, operational, license defense and courtroom hurdles. Beth and Todd Collis are both respected in defending professionals before the State Medical Board of Ohio, Ohio Board of Nursing and other licensing boards.

Pandemic Prompts New Mental Health Resources for Ohio Medical Professionals, Public

Resources are available to help health care workers struggling with mental health issues.

For a health care industry that was already stretched thin, the pandemic has brought many new challenges. Health care workers continue to work long hours, caring for patients who often do not recover from the disease. They have seen death and long-term illness in not only the elderly and people with compromised immune systems, but also in the young and otherwise healthy population. They have seen their friends, colleagues and family members infected by the disease in ways that we could not have imagined in early 2020.

Despite the many challenges that we all face, resources are available to help the general public, and there are some specifically for medical professionals. The National Suicide Prevention Lifeline is a 24/7 free call service which connects the caller to compassionate, accessible care with experienced suicide prevention counselors. To reach the Lifeline, call toll free to 800-273-8255.

In 2020, Congress designated the new dialing code 988, to be used to quickly and easily connect a caller to the suicide prevention hotline. While it has taken some time to establish, on July 16, 2022, the new hotline will be fully operational. Even once the three-digit code is operational, you can continue to call 800-273-8255 if you are experiencing suicidal thoughts or emotional distress.

Often, medical professionals facing stress, burnout or other mental health issues have been reluctant to seek counseling or any mental health services for fear that they would be reported to the State Medical Board of Ohio and possibly face public discipline or public monitoring. However, the Medical Board has enacted a non-disciplinary, confidential monitoring program for eligible licensees who have a mental or physical health problem or may need treatment or counseling to continue practicing safely. See Ohio Administrative Code 4731-28-01 for eligibility requirements Rule 4731-28-01 – Ohio Administrative Code | Ohio Laws

In addition, many employers offer free, confidential counseling and mental health services for their employees. Mental health professionals are encouraged to reach out to their employee assistance program (EAP) to seek their own confidential counseling or mental health services.

In Ohio, physicians and other medical health professionals should consider contacting the Ohio Physicians Health Program OhioPHP for an assessment and for assistance seeking counseling services.

As always, if you have any questions about this post or the State Medical Board in general, feel free to contact health care attorneys at Dinsmore and Shohl, Beth Collis (Beth.Collis@Dinsmore.com) or Todd Collis (Todd.Collis@Dinsmore.com).


Ohio Registered Nurses and Advanced Practice Nurses – License Renewal Final Deadline Is October 31, 2021

The renewal window for registered nurse (RN) and advanced practice registered nurse (APRN) licenses issued by the Ohio Board of Nursing (Board) opened on July 1, 2021.  The final deadline for renewal is Oct. 31, 2021. Renewal is completed online using the Ohio eLicense system.

If you do not file a complete renewal application and/or pay the required fee by Oct. 31, 2021, your license will lapse. An RN or APRN in Ohio whose license has lapsed is not authorized to work as a nurse until their nursing license is reinstated by the Board. It is a disciplinable offense to engage in the practice of nursing on a lapsed nursing license.

Additional information may be required. The renewal application includes but is not limited to questions concerning criminal, licensure, mental health and alcohol/drugs matters. All information provided in the renewal application is required to be true and accurate. Depending on the response given to certain questions in the renewal application, uploading an explanation and certified copies of certain specific documents may also be required. If you are required to provide any additional documentation as part of your renewal application, the documents must be uploaded through the online system. No hard copies of documents will be accepted.

In certain cases, the renewal application may be forwarded to the Board’s Compliance Unit for review and a Board investigator may contact the nurse to obtain additional information. In other cases, a Consent Agreement may be offered to the nurse to resolve a disciplinable offense instead of preceding to an administrative hearing.

If you do not understand a question in your renewal application or do not know what additional information to upload with your renewal application, it is recommended to obtain experienced legal counsel to assist you before submitting your renewal application, speaking with any Board investigator, or signing a Consent Agreement.

For additional information visit: https://nursing.ohio.gov/wp-content/uploads/2021/06/Website-renewal-2021-July.pdf

If you have questions about this post or the Ohio Board of Nursing, contact Todd Collis at (614) 628-6962, or Beth Collis at (614) 628-6945.

The Ohio Board of Nursing Disciplinary Process

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A nurse alleged to have violated the Ohio Board of Nursing’s (“Nursing Board”) laws or rules is subject to discipline by the Nursing Board. Actions for which a nurse can be disciplined can be found here. This article is a general guideline to the Nursing Board’s disciplinary process.

Stage One – Complaint

Any member of the public is permitted to file a Complaint with the Nursing Board. Additionally, under Ohio Revised Code §4723.34(A), an employer of nurses who knows or has reason to believe that a current or former nurse employee engaged in conduct that would be grounds for disciplinary action by the Nursing Board must report to the Nursing Board the name of such current or former employee. The Nursing Board’s Complaint form can be found here. Generally, the Complaint includes the identification of the Complainant, the nurse at issue, and the allegations of the conduct at issue.

Stage Two – Board Investigation

Following the Nursing Board’s receipt of a Complaint, the Complaint is assigned to one of the Nursing Board’s Investigators (also called a Compliance Agent). Typically, the Investigator will speak with and/or obtain documents regarding the allegations in the Complaint from the person who filed the Complaint. In many instances, the Investigator will also contact the nurse at issue either by phone or email and request to speak with the nurse about the allegations in the Complaint or request that the nurse provide a written explanation of the allegations in the Complaint. Generally, a nurse’s participation in the Board’s investigation is voluntary. It is recommended to obtain legal counsel before speaking with or responding in writing to an Investigator, however, after consulting with legal counsel, there are circumstances when it is recommended to cooperate with the Investigator to the extent that it is in the best interest of the nurse to do so.

Stage Three – Notice

Following the investigation, the Nursing Board’s Supervising Member reviews the matter and decides whether to not proceed with disciplinary action against the nurse. A decision not to proceed with disciplinary action can be made because there is not sufficient evidence to prove that a violation of Nursing Board law or rule has occurred or, although there is evidence to prove that a violation of a Nursing Board law or rule occurred, the Nursing Board nevertheless determines that such violation is a “minor violation”. The Nursing Board’s policy concerning minor violations can be found here. If the Supervising Member decides to proceed with disciplinary action, a written Notice of Opportunity for Hearing (or Notice of Suspension) is issued to the nurse in which the nurse is given the opportunity to request and have an Administrative Hearing in connection with the allegations in the Notice.  The time frame (typically 30 days) and manner (typically in writing or email) in which the nurse may request a Hearing is set forth in the Notice.  If the nurse does not request a Hearing either timely or in the manner set forth in the Notice, the nurse will be deemed to have waived their rights to a Hearing and the Nursing Board has authority to impose discipline it deems appropriate without further input from the nurse.

Stage Four – Consent Agreement

In certain cases, the Nursing Board will offer a Consent Agreement to the nurse instead of having the Hearing.  A Consent Agreement is a written agreement between the Nursing Board and the nurse specifying certain admissions by the nurse and detailing the discipline to be imposed upon the nurse.  Consent Agreements have a broad range of discipline including reprimand, probation, and/or suspension, and have disciplinary requirements including but not limited to fines, CEUs, background checks, employer reports, drug screens, dependency and/or psychological evaluations, treatment provider and medication reports, and temporary or permanent practice and/or narcotic restrictions.  It is recommended to obtain legal counsel before signing a Consent Agreement so that the nurse understands their rights, the terms and conditions of the Consent Agreement, and (although no two cases are identical) whether or not the discipline in the Consent Agreement is reasonably similar in scope to similarly situated cases.  At the Consent Agreement stage, there may also be some opportunity negotiate the terms and conditions of the Consent Agreement.

Stage Five – Hearing

If the Nursing Board does not offer a Consent Agreement or if the nurse does not accept a Consent Agreement offered by the Nursing Board, the matter will proceed to the Hearing. At the Hearing, the Nursing Board is represented by an Ohio Assistant Attorney General who presents the Nursing Board’s evidence concerning the allegations in the Notice to a Hearing Examiner. The nurse may either be represented by legal counsel or by themself and may present evidence refuting the allegations in the Notice, as well as evidence of the nurses good nursing practice and character either by their own testimony and/or through character witnesses and other documentary evidence. The Hearing Examiner receives all evidence and prepares for the Nursing Board a written Report and Recommendation which outlines all the evidence received at the Hearing and recommends a discipline.

Stage Six – Board Meeting

The Report and Recommendation is considered by the full Nursing Board at a regularly scheduled Board Meeting. The Nursing Board meets every other month. Typically, the nurse (and counsel, if represented) will present a statement to the Nursing Board in their support. The Nursing Board has the authority to adopt the recommended discipline or it can reject the recommended discipline and order such discipline as it deems appropriate under the circumstances. Although a nurse has the right to appeal the Nursing Board’s decision to the Court of Common Pleas, the Nursing Board’s decision can be overturned by the Court only where the Court determines that the Nursing Board’s decision was not supported by reliable, probative, and substantial evidence and is not in accordance with law (See Ohio Revised Code §119.12(D)).

Conclusion – Know Your Rights

At each stage of the Nursing Board’s disciplinary process, a nurse has legal rights.  It is recommended to obtain legal counsel in Nursing Board disciplinary matters because failure to understand and/or exercise a nurse’s legal rights can result in unintended consequences some of which cannot be reversed. Contact Todd Collis (614) 628-6962 Todd.Collis@Dinsmore.com or Beth Collis (614) 628-6945 Beth.Collis@Dinsmore.com if you have any questions.

The information in this article is general in nature and is not, nor intended to be, legal advice.  You should consult an attorney for advice regarding your individual situation.

Admissions to Board Investigator Can Be Used Against Physician in Criminal Trial

On December 15, 2020, the Ohio Supreme Court ruled 6-1 that a physician’s admissions made to an Ohio Medical Board investigator can be used against the physician in his criminal trial.

In 2017, three patients accused Dr. James Gideon of inappropriate touching during office visits.  Gideon told Bluffton police he did not inappropriately touch any patients. Subsequently, however, an Ohio Medical Board investigator made an unannounced visit to Gideon’s office. Gideon, who was aware of the Ohio Medical Board legal requirement to cooperate with and provide truthful answers to the investigator, admitted to “touching certain areas on the patients and succumbing to temptation”. The investigator provided these admission to Bluffton police.

Gideon was charged with three misdemeanor counts of sexual imposition. At trial, he argued that the statements he made to the investigator should be suppressed based on the Fifth Amendment protection from being forced to incriminate himself.

The trial court did not suppress Gideon’s incriminating statements because it found that Gideon voluntarily made the statements to the investigator. Gideon was found guilty in all three cases and was sentenced to 180 days in jail.

On appeal, the appeals court ruled that the trial court should have suppressed the incriminating statements because his statements were not voluntary.

Upon review, the Ohio Supreme Court reviewed that the Fifth Amendment to the U.S. Constitution includes the right to remain silent where a person’s replies might be used against the person in future criminal proceedings.

The Ohio Supreme Court held that, in order to determine that Gideon’s statements were coerced in violation of his Fifth Amendment rights, Gideon had to demonstrate that (i) he subjectively believed that failure to cooperate with the investigator would lead to the loss of his license, and (ii) his belief that he was being threatened was objectionably reasonable by providing some evidence of pressure beyond merely directing him to cooperate in the investigation. The Ohio Supreme Court found that Gideon’s belief that he was being threatened was not objectively reasonable under the facts and circumstances of the investigation. Health care and other professional licensees in Ohio must be aware that information provided to an investigator – whether that is an investigator employed by the Medical Board, Nursing Board, Pharmacy Board, or any other board or agency – can be used against the licensee in a disciplinary action and in a criminal proceeding.  Legal counsel is recommended for any licensee in connection with any Board investigation or disciplinary action.

If you have any questions about this article or the State Medical Board of Ohio, please feel free to contact attorney Beth Collis at (614) 628-6945, or attorney Todd Collis at (614) 628-6962.

Extension to Renew Ohio LPN licenses

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Ohio LPN licenses expire on November 1, 2020.  However, the Ohio Coronavirus Omnibus Act, H.B. 197, effective March 27, 2020, authorizes extending Ohio LPN licenses that expire during the declared emergency.

Ohio LPN licenses will remain valid until the earlier of either 90-days after the date the emergency ends or December 1, 2020, unless revoked, suspended, or otherwise subject to discipline or limitations.

The Ohio LPN license renewal window is scheduled to begin on July 1, 2020 and the Ohio Board of Nursing encourages Ohio LPNs to renew their licenses between July 1 and October 31, 2020.  However, if the declared emergency continues, Ohio LPN licenses that are not renewed will not expire/lapse until the expiration date established in accordance with HB 197.

If the period to renew Ohio LPN licenses is extended, the Ohio Board of Nursing will notify LPNs through the website, social media, and email. To receive information from the Ohio Board of Nursing, it is strongly recommended that you ensure that the Ohio Board of Nursing has your most up to date contact information, including your email address.

Renewal is to be completed online using the Ohio eLicense system, a comprehensive professional regulatory license system used by a variety of state licensing boards, the same system used during the last renewal period.

Please note that incomplete applications will not be accepted by the online system.

Additional Documents May Be Required:

If you respond Yes to any of the questions on the renewal application, you may be asked to provide documentation of citizenship, court documents or other information that may be required as part of your renewal application  Be prepared to upload the documents electronically through the online system. The Ohio Board of Nursing will not accept hard copies of supporting documentation.

For information about the LPN renewal process, see:
LPN Renewal 2020 and Ohio Board of Nursing

If you have any questions on how to respond to questions on the renewal application, need to disclose a conviction or other conduct on your application or need assistance to complete the renewal application, you should consider hiring experienced counsel to assist. As always, if you have any questions about this post or about the Ohio Board of Nursing in general, please feel free to contact Beth Collis or Todd Collis.

NCSBN Offering Free Online COVID-19 Courses for Health Care Professionals

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The National Council of State Boards of Nursing (NCSBN) is an organization through which state boards of nursing work together on matters of common interest and concern affecting the public health, safety and welfare.

NCSBN is offering free online COVID-19 courses for health care professionals. The courses provide new, established and returning nurses with training and resources during the COVID-19 pandemic.

Nurses and other health care workers are invited to self-enroll through the ICRS Connections Catalog. Enrollment questions should be directed to icrs@ncsbn.org.

For more information, visit their website.

If you have any questions about this post, contact Beth Collis or Todd Collis.

Ohio Counselor, Social Worker, and Marriage and Family Therapist Board Issues Emergency Rule 4757-5-13 Regarding Teletherapy

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On April 6, 2020, the Ohio Counselor, Social Worker, and Marriage and Family Therapist Board (“CSWMFT Board”) filed emergency rule 4757-5-13. The rule will remain in effect until August 4, 2020. In its announcement, the CSWMFT indicated that the emergency amendments to the rule expand access to teletherapy services for clients by:

  • clarifying that no training is required prior to providing teletherapy, however, the rule requires that licensees provide services only if they can competently provide such services
  • waives the requirement to hold a face to face meeting in-person or via video prior to rendering services;
  • allows for verbal consent when written consent cannot be obtained; and
  • follows federal guidance regarding HIPAA compliant technology.

In its announcement, the CSWMFT Board also indicated that licensees should consider the following questions if they are going to provide teletherapy:

  1. Do I have the skills and competencies necessary to provide teletherapy? If the answer is no, what do I need to do to develop those skills?
  2. Do I have the right recordkeeping practices in place?
  3. Does my liability insurance allow me to provide teletherapy?
  4. Is my employer supportive of my doing teletherapy?
  5. Are insurers whom I will be billing allowing for teletherapy?
  6. If you are planning to continue to provide services to existing clients, who among your clients might benefit from teletherapy? Who might face challenges?
  7. If you are working with new clients via teletherapy, are you prepared to assess the appropriateness of video or phone therapy with the clients?
  8. How do you ensure equitable opportunities for all clients? Are you prepared to refer out any clients whom you cannot serve because of insurance issues, the presenting problem, or client issues with being served via video or phone?
  9. Do the presenting problems you often treat translate well over teletherapy?

For the full CSWMFT Board Statement, go here.

As always, if you have any questions about this post or about the Ohio Board of Nursing in general, feel free to contact Beth Collis or Todd Collis.

Ohio Nurses: How to comply with a Nursing Board Order or Consent Agreement during the COVID-19 Stay at Home Order

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Many nurses who are currently being monitored by the Ohio Board of Nursing, under the terms of a Consent Agreement or a Board Order, have asked how they can comply with the terms of these Orders, while under the State of Ohio Stay at Home Order in effect until May 1, 2020.

In general, each nurse needs to continue to comply with all terms and conditions of your Board Order or Consent Agreement. If you unable to comply in any way, contact your monitor immediately. While the Nursing Board staff is currently working remotely, the staff has access to emails and they are continuing to respond to questions and requests.

Random Drug testing:

Nurses who have stopped daily call ins to First Source, based upon the Ohio Department of Health Stay at Home Order, need to begin daily calls effective Monday, April 20, 2020.

Random Drug Testing will be scheduled after May 4, 2020. Testing will include hair and blood specimens in addition to urine specimens. These highly sensitive tests will be able to detect if you ingested alcohol, medications or illegal substances in the days or weeks before the test. So, just because you are not submitting to random drug testing does not mean that you can consume alcohol (if prohibited by your Board Agreement or Order) or that you may use medications not prescribed to you or illegal substances.

Any requirement that is not met, such as a missed screen or support group meeting attendance, or a positive screen based on the use of hand sanitizer will be evaluated considering the coronavirus (COVID-19).

Attendance at AA meetings:

You may now “attend” AA meetings online.If you participate in an on-line support group meeting or discussion, please document this on Form #4 and include dates and type of meeting attendance. A co-signor is not necessary.

Here are links for on-line meetings:
(AA)
(CA)
(NA)

If you participate in an on-line meeting or discussion, please document this on form #4 and include the date of the meeting and the type of meeting attended. A co-signor is not necessary. Again, contact your monitor if you choose to “attend” an AA meeting online.

Request to modify the terms of your Consent Agreement:

The Nursing Board has also received multiple requests to remove Board monitoring and restrictions or to modify Board Orders. Board actions will not be held in abeyance or suspended. Board Orders are final and there is no provision to modify a Board Order. The Board will not alter permanent restrictions in Consent Agreements or Orders.

Ohio Department of Health has established an outline for essential healthcare workers, which can be found here.

More info about Covid-19 and Ohio can be found here.


As always, if you have any questions about this post or about the Ohio Board of Nursing in general, feel free to contact Beth Collis or Todd Collis.

Ohio Board of Pharmacy Takes Additional COVID-19 Response Efforts

On March 24, 2020, the State of Ohio Board of Pharmacy (“OBP”) took additional COVID-19 response efforts to protect the health and safety of Ohioans during the COVID-19 outbreak. These efforts include, but are not limited to:

  • Authorized expedited licensure of drug distributors; and
  • Authorized sale and shipment of non-reportable dangerous drugs that are in shortage by unlicensed, out-of-state facilities.

The OBP also reminded its licensees that pharmacies and terminal distributors of dangerous drugs are not required to submit a notification to the OBP for any temporary closures or reduction in operating hours. If modifying operating hours, a pharmacy must update signage to reflect the change in store hours.

Read more HERE and HERE.

As a reminder, the OBP also implemented required infection control procedures effective March 19, 2020.

Read more HERE.

If you are seeking guidance concerning obtaining expedited licensure as a drug distributor or have questions concerning OBP requirements during COVID-19, contact Todd Collis.

 

State of Ohio Board of Pharmacy Implements Infection Control Procedures in Face of Corona Virus

Updated 3/19/2020

The State of Ohio Board of Pharmacy issued new requirements to implement safeguards to allow pharmacy professionals employed by a terminal distributor to practice pharmacy in a safe and effective manner.

The Ohio Pharmacy Board issued the following (emphasis added):

Section 4729.55 of the Revised Code requires a pharmacy to implement adequate safeguards that allow pharmacy professionals employed by a terminal distributor to practice pharmacy in a safe and effective manner. This includes implementing safeguards to protect pharmacy professionals (pharmacists, interns, technician, and support personnel) and patients during a public health emergency.

To comply with the requirements of section 4729.55 of Revised Code, the Board has determined the following steps shall be implemented by all pharmacies located in Ohio starting no later than 5 p.m. on Thursday, March 19, 2020 to ensure the practice of pharmacy can be conducted in a safe and effective manner:

  • For pharmacies open to the public, consider developing a process for older adults (60+), pregnant women, and individuals with chronic health conditions to pick up medications without waiting in line (i.e. post signs directing to drive-thru, offer curb-side delivery, mail delivery, senior hours, etc.).
  • Implement infection control procedures, especially for waiting areas, to include the following:
  • Pharmacies with workspaces that currently allow patients to get closer than the minimum recommended distance of 3 feet should post signage or utilize other methods to ensure patients who are waiting are maintained at a safe distance. NOTE: This does not apply to patients who must interact with pharmacy staff (i.e. for purposes of payment, immunizations, etc.) or pharmacies that are not open to the public.
  • Pharmacists and pharmacy interns shall no longer be permitted to administer immunizations or other injections without standard protective measures, which includes gloves and proper hand hygiene (i.e. routinely washing hands with soap and water for at least 20 seconds). Standard protective measures do not include the use of masks or gowns.
  • Pharmacists and pharmacy interns shall not administer any immunizations or other injections to patients displaying or reporting symptoms of respiratory illness, including any of the following:
    • Fever (NOTE: This does not require mandatory temperature checks);
    • Cough; or
    • Shortness of breath.
  • Pharmacy professionals who are older adults, pregnant women, or individuals with chronic health conditions shall not be prohibited from wearing appropriate PPE to operate within a pharmacy.
  • Regularly clean and disinfect counters, credit/debit card devices, waiting areas, and other spaces where public interaction occurs with an EPA-approved disinfectant. Clean at least every hour or after every 10 patients, whichever is more frequent. If cleaning and disinfecting products are in short supply, the Ohio Department of Health has developed the following guidance. Read here.
  • If available, place alcohol-based hand sanitizer next to the checkout window so people can sanitize their hands after using common items, like the pen used to sign for prescriptions or devices used to process credit/debit card transactions. REMINDER: Manual signatures from patients are not required by Board of Pharmacy rule (see Important COVID-19 Reminders section of this guidance document for more information).
  • Provide regular breaks for staff to engage in proper hand hygiene (i.e. routinely washing hands with soap and water for at least 20 seconds).
  • Monitor pharmacy staff for symptoms of respiratory illness, including any of the following:
    • Fever (NOTE: This does not require mandatory temperature checks. However, the Ohio Department of Health recommends pharmacies take staff temperatures once per shift);
    • Cough; or
    • Shortness of breath.

Staff exhibiting or reporting any of these symptoms must be sent home.

Failure to comply with the requirements set forth in this document may result in administrative discipline for the pharmacy and the pharmacy’s responsible person.

As always, if you have any questions concerning this post, contact Todd Collis or Beth Collis.