The Ohio Board of Nursing’s Practice Intervention and Improvement Program

The Ohio Board of Nursing is the state agency that regulates the practice of nursing in Ohio. The mission of the Nursing Board is to protect the public by ensuring that nurses have the skills to provide care to patients. In instances where a nurse has violated the Ohio Nurse Practice Act, the Nursing Board has the authority to take a disciplinary action, such as to suspend or revoke a nurse’s license to practice in Ohio. However, in instances where the Nursing Board has reason to believe that a nurse has a deficiency in their practice that may be corrected, the Board may require the nurse to seek additional education and/or training.

The Nursing Board’s Practice Intervention and Improvement Program (“PIIP”) permits the Nursing Board to offer a nurse an opportunity to seek remedial education and training in a specific area instead of taking disciplinary action against a nurse who has a practice deficiency. The PIIP program is considered non-disciplinary and does not constitute a restriction or limitation on a nurse’s license. Participation in PIIP is confidential.

The criteria the Nursing Board uses to identify an individual’s practice deficiency includes, but is not limited to:

(1) Whether the public will be adequately protected from unsafe practice if the individual enters PIIP;
(2) Whether the individual’s practice deficiency resulted in harm to the patient;
(3) The likelihood that the identified practice deficiency can be corrected through remediation;
(4) The frequency of the occurrence of the practice deficiency;
(5) Whether the individual is eligible for participation in PIIP under 4723-18-03 of the Administrative Code; and
(6) Whether the individual has a mental or physical impairment that contributed to the practice deficiency.

If the supervising member believes, after investigation and review, that the individual’s practice deficiency can be successfully corrected through participation in PIIP, the Nursing Board may choose to take no disciplinary action. This decision is generally reached, if the individual enters into a Participatory Agreement with PIIP, complies with the terms and conditions of PIIP, and successfully completes PIIP.

The PIIP Participatory Agreement includes, but is not limited to, provisions that:

(1) Identify the practice deficiencies and the specific remediation (including educational interventions) the participant must complete;
(2) Require the participant to pay all expenses for the required remediation;
(3) Require the participant to provide the Participatory Agreement to a manager of the participant’s employers;
(4) Require the participant to participate in workplace monitoring;
(5) Require the participant to cause all workplace monitors to provide remediation and to send written progress reports regarding the participant’s progress to PIIP at specified intervals;
(6) Require the participant to submit a written personal progress report containing the information required by PIIP to PIIP at specified intervals; and
(7) Specify the terms and conditions the participant must meet to successfully complete the remediation, including the time frames for successfully completing both the educational intervention and workplace monitoring components of the remediation.

Generally, to comply with PIIP, the nurse will identify a nurse educator who will prepare an individualized course of study for the nurse. The course may include a series of written materials to review or a list of on-line continuing education courses that must be completed. The course of study is almost always tailored to the individual need of the nurse and generally does not require the nurse to return to complete coursework in a nursing school setting or to repeat an entire nursing course. The educator will generally meet individually with the nurse to evaluate their skills to determine if the deficiency in their practice has been remediated. In most instances, the nurse can complete the remedial education in a matter of weeks.

A PIIP participant can be terminated from PIIP for reasons including, but not limited to, the failure to: 1) comply with the Participatory Agreement; 2) progress through or successfully complete the educational intervention in the manner and time frame required; or 3) incorporate learned knowledge and skills into practice.

In addition to avoiding public discipline, a participant who successfully completes PIIP will not be reported to the National Council of State Boards of Nursing disciplinary data bank or the National Practitioner Data Bank (NPDB) unless the Nursing Board imposes disciplinary action against the participant.

As always, if you have a question about this post or the Ohio Board of Nursing in general, please feel free to contact one of the attorneys at the Collis Law Group LLC at 614-486-3909 or email me at beth@collislaw.com.

 

TYPICALLY, A CONSENT AGREEMENT WHICH HAS BEEN SIGNED BY A NURSE AND THE OHIO BOARD OF NURSING IS FINAL AND GENERALLY WILL NOT BE MODIFIED

In our private practice of representing nurses before the Ohio Board of Nursing, we are often contacted by nurses who have entered into a Consent Agreement with the Nursing Board and who want to change the terms after the Consent Agreement has already been approved by the nurse and the Nursing Board.  Typically, however, a Consent Agreement which has been approved by the nurse and the Nursing Board is final and will not be renegotiated.

A Consent Agreement is a legally binding contract that a nurse may enter into with the Nursing Board to resolve a pending disciplinary matter.  For example, in some instances, a nurse will agree in the Consent Agreement to allow their license to be placed on suspension or on probation, and to be subject to various conditions, such as random drug screens or completion of CEUs in addition to CEUs required for license renewal.  The time to propose and negotiate changes to the Consent Agreement is before the Consent Agreement has been signed by the nurse and the Nursing Board.

While certain provisions in the Consent Agreement are considered by the Nursing Board to be non-negotiable, there are certain sections of the Consent Agreement which may be negotiated.  For example, information pertaining to completed treatment for impairment or other relevant evidence in support of the nurse’s defense may be negotiated to be included in the Consent Agreement.  Additionally, there are certain instances where the Board will negotiate the duration of a suspension or probation based on the evidence in the matter.

We are also contacted by nurses who have violated their Consent Agreement and want to attempt to negotiate more favorable or different terms with the Nursing Board.  Although there is a “standard” provision in most Consent Agreements permitting modification of the Consent Agreement upon the written agreement of the nurse and the Board, it is our general experience that the Nursing Board does not re-negotiate Consent Agreements.  For example, if a nurse is required to pay a $500 fine within 6 months of the Consent Agreement taking effect and the nurse fails to do so, it is our general experience that the Nursing Board will not agree to modify the terms of the Consent Agreement to require the nurse to pay a $250 fine instead. Similarly, if a nurse is required to submit to random drug screens for 1 year and tests positive for drugs – even on 1 screen – the Board will not modify the Consent Agreement to eliminate the random drug screening requirement.

Additionally, failure of a nurse to comply with the terms of the Consent Agreement generally results in the Nursing Board suspending the nurse’s license based on a violation of the Consent Agreement.  If the Board suspends the nurse’s license based on the nurse’s failure to comply with the terms of the Consent Agreement, the earliest the nurse could have their license reinstated would be at the Board meeting subsequent to the suspension, and, in certain instances, it can take longer.  In this regard, please note that the Nursing Board meets every other month.

Prior to entering into a Consent Agreement with the Nursing Board, it is important that you fully understand and agree to all terms and conditions of the Consent Agreement.  After the Consent Agreement is signed by the nurse and by the Nursing Board, the Consent Agreement is a legally binding contract between the nurse and the Nursing Board which is, generally, considered by the Nursing Board to be final and not subject to modification.

As always, if you have any questions about this post or about the Ohio Board of Nursing in general, please feel free to contact one of the attorneys at the Collis Law Group LLC at 614-486-3909 or email me at beth@collislaw.com.

 

Ohio RNs – License Renewal Time!

On July 1, 2017, the renewal window opened for registered nurses in Ohio.  The sooner you renew, the better.

 Cost and Timing:

Prior to September 15, 2017, the fee to renew your RN license is $65.00.  An RN Renewal Application filed after September 15, 2017 will also include a $50.00 late fee.  The RN license renewal window closes October 31, 2017.  After October 31, 2017, your RN license is considered by the Ohio Board of Nursing (“Nursing Board”) to have lapsed and you are unauthorized to practice nursing in Ohio until reinstated. 

For instructions on renewing your RN license and to review the questions in the RN Renewal Application go to: http://www.nursing.ohio.gov/PDFS/Forms/Samples/SAMPLE-RN_Renewal_App-2017.pdf

 When you are ready to renew your RN license, go to: http://www.nursing.ohio.gov/forms.htm#RenewalForms

Questions on the RN Renewal Application:

The RN Renewal Application includes, but is not limited to, questions concerning your employment, residency status, Social Security number, criminal matters, medical or mental health matters, and substance abuse matters.  You are required to answer all questions on the RN Renewal Application truthfully and accurately.  Additionally, there are certain instances where you are required to upload with your RN Renewal Application specific documents and a written statement explaining your response to a particular question(s) in the RN Renewal Application.

 Based on the response(s) in your RN Renewal Application, the Nursing Board may open an investigation.  If an investigation is opened, you may be contacted by a Nursing Board investigator by phone or email requesting additional information or documentation concerning your response(s). 

If you do not understand a particular question(s) in the RN Renewal Application, or do not know what additional information to submit to the Nursing Board in support of your RN Renewal Application, it is recommended to obtain experienced legal counsel to assist you with preparation of your response or before speaking with a Nursing Board investigator. 

As always, if you have any questions about this post or the Ohio Board of Nursing, contact one of the attorneys at the Collis Law Group LLC at 614-486-3909 or go to our website at http://www.collislaw.com for more information.

How a DUI may affect your Ohio nursing license

Happy New Year!

Over this holiday weekend, I have received calls from several health care professionals who have been charged with a DUI inquiring how or whether a criminal charge may affect their license to practice as a nurse in Ohio.

First, it is important to understand that the Ohio Nursing Board may take a disciplinary action against a nurse for certain criminal convictions, even if the charge does not relate to the practice of nursing. Second, it is important to understand that a DUI is not considered a “minor traffic violation”.  A DUI, even if reduced to a lesser offense, such as disorderly conduct or reckless operation of a vehicle, is still of concern to the Nursing Board and may result in a sanction to the nurse’s professional license.

If you have been charged with a DUI, you should seek competent legal counsel to assist you through the criminal case process.  In certain instances, you may be accepted into a treatment program which, if successfully completed, may result in no criminal conviction or the charges may be reduced to a less serious offense.

A conviction for a DUI or certain other criminal offenses may result in negative consequences for your professional license.  While you are not required to immediately notify the Ohio Nursing Board that you have been charged with or convicted of a criminal offense, you may need to disclose the criminal matter when you renew your professional license, depending on the matter.  At the time you renew your license, you should consider hiring legal counsel to assist you to accurately respond to the questions on the renewal application and to prepare any documents necessary or required by the renewal application.

The way in which the Ohio Nursing Board handles your criminal case will depend on a variety of factors.  In determining what sanction, if any, that the Ohio Nursing Board might impose, the Ohio Nursing Board will consider factors including but not limited to the following:

  • the seriousness of the matter;
  • whether the matter relates to your professional practice;
  • whether the matter is your first criminal matter; and
  • whether you fully cooperate and complete any requirements of the Court.

Depending on the circumstances of your matter, the Ohio Nursing Board can order the nurse to submit to a chemical dependency assessment to determine if treatment is needed and/or can require the nurse to submit to a period of random drug testing.  Additionally,  the Ohio Nursing Board has the authority to suspend a nurse’s license and/or can place the nurse on probation.

If you need treatment, you should obtain comprehensive treatment. The Ohio Nursing Board does not maintain an approved list of treatment providers.  The nurse may choose any treatment center that will provide them with the treatment needed for their addiction.

As always, if you have any questions about this post or about the Ohio Board of Nursing in general, please contact one of the attorneys at the Collis Law Group at 614-486-3909 or email me at beth@collislaw.com.

Although legal in other states, nurses have been disciplined for testing positive for marijuana in Ohio

Twenty-five states and the District of Columbia have legalized marijuana in some form.  Four states and the District of Columbia have legalized marijuana for recreational use.  Some states allow residents to possess up to one ounce of marijuana and to even grow up to six plants.  While there have been various marijuana initiatives in Ohio, to-date it is illegal to possess, sell, or cultivate marijuana in Ohio.

Historically, the Ohio Board of Nursing has taken a strong position against marijuana usage.  For example, where a positive test for marijuana in an employment drug screen is reported to the Board, the Board routinely places the nurse on probation for a period of at least one year, which typically includes random drug testing and can include narcotics as well as practice restrictions.

Even if a nurse has traveled outside of Ohio and consumed or smoked marijuana in a State where it is legal, if the nurse returns to Ohio and is reported to the Board for a positive drug screen, the nurse should expect to be subjected to discipline by the Board.

In our practice, we have seen nurses reported to the Board because they failed pre-employment drug tests who were subjected to discipline including at least one year random drug testing.  A nurse does not have to be actively practicing nursing in order be found by the Board to be impaired. By simply testing positive for marijuana, a nurse can be subjected to discipline.  Employers are required by law to report to the Board any suspected violation of the Ohio Nurse Practice Act.

Before you consider using marijuana on your next trip to Colorado or Washington, realize that if you test positive on a drug screen – even weeks later when you return to Ohio – you should anticipate that you will be reported to the Board and subjected to discipline.

As always, if you have any questions about this post of the Ohio Board of Nursing in general, please contact one of the attorneys at the Collis Law Group LLC at 614-486-3909.

 

46 Ohio nurses did not defend themselves?!

 

Yesterday, I attended the January meeting of the Ohio Board of Nursing.  On the morning agenda, the Members of Nursing Board voted to issue a Notice of Opportunity for Hearing, Notice of Immediate Suspension, or Notice of Automatic Suspension to over 60 nurses.

Additionally, the Nursing Board voted to impose a final disciplinary sanction (suspension, revocation, or limitation) on over 100 nurses’ professional licenses in Ohio.  I was struck and saddened to learn that in 46 casesthe nurse failed to request a hearing and never introduced ANY evidence in their defense.

If a nurse fails to request a hearing, the Nursing Board is authorized to impose any sanction from dismissal of the case to permanent revocation of the nurse’s license.  If a nurse fails to request a hearing, the nurse may not submit any evidence in their defense.

It cannot be understated the positive effect that can result when a nurse presents “their side of the story”, explains what happened, and puts the Nursing Board’s allegations into context.  The Nursing Board members like to see that the nurse understands the gravity of the allegations, accepts responsibility (where warranted), and fights for their license.  In certain instances, where the nurse presents evidence rebutting or refuting the Nursing Board’s charges, the Nursing Board has been known to dismiss certain counts in the Notice or dismiss an entire case against the nurse.

At the meeting yesterday, based on mitigating evidence that was introduced in one case, the Nursing Board modified the recommendation of the Hearing Examiner from a 6 month suspension to no suspension and simply placed the nurse on probation.

As a nurse, you have worked hard for your professional license.  If you are notified by the Nursing Board that they propose to take an action against your license, request a hearing and defend yourself.  While you may represent yourself before the Nursing Board, please note that the Nursing Board will be represented by an attorney from the Office of the Ohio Attorney General who will prosecute the case on behalf of the Nursing Board.  It is recommended that you should also have experienced counsel to represent you in this stressful and difficult process.

If you have any questions about this blog post or the Ohio Board of Nursing in general, please feel free to contact one of the attorneys at the Collis Law Group, LLC at 614-486-3909 or email me at beth@collislaw.com.

Ohio RNs and APNs, time to renew your license!

If you are licensed as a Registered Nurse or Advanced Practice Nurse in the State of Ohio it is time to renew your professional license.

As part of its electronic renewal system, the Ohio Nursing Board assigns each nurse a unique User ID and Password.  You can access this information through the Board’s website at:https://license.ohio.gov/lookup/password.asp

You can save money by renewing your license before July 1, 2015.  Registered nurses who renew before July 1, 2015, must pay Sixty Five Dollars ($65.00).  After July 1, 2015, the cost goes up to One Hundred Fifteen Dollars ($115.00).

Advanced practice nurses (APRN) must renew their RN license and each of their Certificates of Authority (COA).  Before July 1, 2015, the renewal fee is Eighty Five Dollars ($85.00) for each COA.  After July 1, 2015, the renewal fee goes up to One Hundred Thirty Five Dollars ($135.00) for each COA.

APRNs with prescriptive authority must renew their RN license, their COA, and their Certificate to Prescribe (CTP).  The renewal fee for the Certificate to Prescribe (CTP) is Fifty Dollars ($50.00) through August 31, 2015.

APRN’s must provide the name and address of their collaborating physician as part of the renewal process.

Maintaining an Active nursing license is your responsibility. Failure to renew your RN license, COA, and CTP (as applicable to you) by August 31, 2015 will result in your RN license, COA, and/or CTP to automatically lapse.  Practicing under a lapsed license, COA, and/or CTP is a disciplinable offense.

As always, if you have any questions about this post or the Ohio Board of Nursing in general, please feel free to contact one of the attorneys at Collis, Smiles and Collis, LLC at 614-486-3909. You may also look for more information at http://www.collislaw.com.