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

Featured

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

Featured

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

Featured

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.

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.

Ohio Counselor, Social Worker, and Marriage and Family Therapist Board Responds to Corona Virus

Featured

In connection with the Corona Virus, we have received numerous inquiries from our Ohio counselor and social worker clients concerning teletherapy services.

The Ohio Counselor, Social Worker, and Marriage and Family Therapist Board (“CSWMFT Board”) recently posted the following information on its website:

The Board’s rules regarding providing teletherapy are established in Ohio Administrative Code Chapter 4757-5-13. Licensees who are considering offering services via teletherapy should be mindful of the following:

  • Independent licensees (LISW, LPCC, IMFT), dependent licenses (LSW, LPC, MFT) working under supervision, and trainees (SWT, CT, MFTT) working under supervision, can all provide teletherapy provided they have training and experience in teletherapy. Examples of training include the completion of continuing education, supervised experience, and peer consultation.
  • Services must be provided to ensure the highest level of confidentiality. Video-conferencing software should be HIPAA compliant.
  • Licensees should carefully consider whether teletherapy is an appropriate means of providing services to individual clients.
  • Licensees must be mindful that ORC 4757 and OAC 4757 apply regardless of how services are provided.
  • Licensees who voluntarily choose to suspend providing services must properly terminate with clients and provide referrals as required in the rules. If a licensee is suspending services in response to a public order to do so, the licensee or their employer is advised to provide information, for example on outgoing voicemail messages or websites, regarding resources in the event a client is in crisis.
  • Insurers establish which services are eligible for reimbursement. Be sure to verify whether you can bill for teletherapy before providing services to a client. The Board has no authority to direct insurers to pay for teletherapy services.
  • Agencies and practices may set their own rules regarding teletherapy. The Board can exercise no authority over these employment/business related decisions.

While the Board staff want to be as helpful as possible, we are not able to provide specific guidance regarding implementing teletherapy. Please consult with peers and supervisors. Additionally, Board staff cannot recommend specific software, nor can the Board recommend specific training programs.

  • As the State of Ohio’s response to COVID-19/Corona Virus evolves, the Board will share information with licenses.

PLEASE ALSO NOTE: The CSWMFT Board also recently posted the following update on its website:

Teletherapy Update – Emergency Rule in Progress

The CSWMFT Board is working with Governor Mike DeWine’s office as well as other State agencies on an emergency rule that will provide flexibility for licensees who are seeking to provide teletherapy. We anticipate the proposed rule will be issued soon and will align with the rules being proposed by the Ohio Department of Medicaid and Ohio Department of Mental Health and Addiction Services. Once the rule is issued, we will provide an update and additional guidance.

Below are some additional resources about teletherapy and COIVD-19:

State of Ohio

https://coronavirus.ohio.gov/wps/portal/gov/covid-19/

https://cswmft.ohio.gov/Home/COVID-19

Counseling

AMHCA Code of Ethics
http://www.nymhca.org/AMHCACodeofEthics.pdf

NBCC
https://www.nbcc.org/Assets/Ethics/NBCCPolicyRegardingPracticeofDistanceCounselingBoard.pdf

ACA
https://www.counseling.org/knowledge-center/mental-health-resources/trauma-disaster/mental-health-professional-counseling-and-emergency-preparedness

ACA
https://www.counseling.org/knowledge-center/mental-health-resources/trauma-disaster/working-with-your-clients?utm_source=informz&utm_medium=email&utm_campaign=covidresources

CACREP
https://www.cacrep.org/for-programs/updates-on-covid-19/
 

Social Work

NASW Ohio Chapter
https://www.naswoh.org/page/telehealth2020

NASW
https://www.socialworkers.org/Practice/Infectious-Diseases/Coronavirus

NASW
https://www.socialworkers.org/includes/newIncludes/homepage/PRA-BRO-33617.TechStandards_FINAL_POSTING.pdf

NASW
https://naswassurance.org/malpractice/malpractice-tips/treading-through-teletherapy-treatment-topics/

Marriage and Family Therapy

AAMFT
http://www.aamft.org/iMIS15/AAMFT/Content/Legal_Ethics/Code_of_Ethics.aspx

AAMFT
https://www.aamft.org/Events/Coronavirus-Event-Status-Updates.aspx?WebsiteKey=8e8c9bd6-0b71-4cd1-a5ab-013b5f855b01

Other

CDC- https://www.cdc.gov/coronavirus/2019-ncov/index.html

NIMH – https://www.nih.gov/health-information/coronavirus

APA – https://www.apa.org/practice/programs/dmhi/research-information/social-distancing

American Telemedicine Association – http://www.americantelemed.org/resources/telemedicine-practice-guidelines/telemedicine-practice-guidelines#.VS_Go40tGUk

http://www.gpo.gov/fdsys/pkg/FR-2011-05-05/pdf/2011-10875.pdf

Medicaid – https://www.medicaid.gov/medicaid/benefits/downloads/medicaid-telehealth-services.pdf

HHS – https://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/notification-enforcement-discretion-telehealth/index.html

Medicare – https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet


In consideration of the rapidly-changing situation in which we find ourselves, we recommend and encourage Ohio counselors, social workers, and marriage and family therapist licensees to frequently visit the CSWMFT Board website. As always, if you have questions about this post or the CSWMFT Board, please contact Todd Collis or Beth Collis.

Ohio Board of Pharmacy Issues Important Notice to all Licensees Regarding Extortion Scam

Featured

The Ohio Board of Pharmacy (“Board of Pharmacy”) recently issued a notice to all Board of Pharmacy licensees to be on alert for a scam being perpetrated against Ohio health care providers.

The Board of Pharmacy instructed that these scammers have been communicating with prescribers and pharmacists stating they are under investigation by the Drug Enforcement Administration (“DEA”), and that their DEA registration will be revoked or suspended, or they will be arrested if they do not agree to pay a fine immediately via phone or fax. The DEA is aware of this scam.

Additionally, individuals posing as Board of Pharmacy or State Medical Board agents are contacting health care providers by phone and/or fax in an attempt to fraudulently obtain payment to resolve a disciplinary matter.

If a licensee of the Board of Pharmacy or State Medical Board faces potential disciplinary action against their license, the licensee will receive an official Notice of Opportunity for a Hearing in writing either via USPS Certified Mail or by personal service.

Verify Questionable Contact

If you are unsure whether any individual claiming to be a Board of Pharmacy or State Medical Board agent or inspector is legitimate, ask for their name and contact information and contact the Board of Pharmacy at 614-466-4143, or the State Medical Board at 614-466-3934.

Compliance Requirements Heightened Under New Pharmacy Board Rules

Featured

Beginning Dec. 1, 2019, pharmacists licensed by the State of Ohio Board of Pharmacy (“Board”) will have new reporting requirements. The Board enacted similar reporting requirements for pharmacy interns, pharmacy technician trainees, and registered and certified pharmacy technicians. These new reporting requirements add to existing compliance considerations and burdens for licensees, registrants, their employers, and owners and operators of retail and institutional pharmacies.

Under the new rules, a pharmacist licensed by the Board must report the following to the Board:

  1. Conduct indicating another Board licensee or registrant is addicted to or is suspected of abusing alcohol, drugs or other chemical substances, or is impaired physically or mentally such that he or she is unfit to carry out his or her professional duties.
  2. Violations, attempts to violate, or assisting in a violation of the Ohio Pharmacy Practice Act, the Ohio Controlled Substances Act, certain other Ohio laws, or any Board rule adopted under such laws, by an individual or entity licensed or registered by the Board.
  3. Conduct by another Board licensee or registrant of unprofessional conduct or dishonesty.

Reports are to be based on the pharmacist’s direct observation or objective evidence. There are certain limited exceptions to the above required reports.

Additionally, a pharmacist licensed by the Board must self-report to the Board:

  1. A criminal conviction within 10 days following the conviction date, except for minor traffic violations, such as speeding or running a red light.
  2. A conviction, guilty plea, or finding of eligibility for intervention in lieu of conviction in Ohio or the equivalent in another jurisdiction within 10 days after being deemed eligible.
  3. Being granted entry into a diversion or deferral program or the equivalent within 10 days after being granted entry.
  4. Being arrested for a felony within 10 days after the arrest.
  5. Any disciplinary action taken by the DEA or another state within ten days of the notice action.

A pharmacist who reports under the new rules will remain confidential; however, he or she may be required to testify in a disciplinary proceeding as to the report. In the absence of fraud or bad faith, a person who reports or testifies is not liable for damages in a civil action as a result of the report or testimony.

Seek legal counsel if you are unsure

Note that certain terms in the new rules are specifically defined. A fact-based review with legal counsel is recommended, because a failure to report in accordance with the new rules may result in a disciplinary action against a licensee or registrant.

If you have any questions concerning your duty to report to the Board under the new rules, please contact Eric Plinke, Todd Collis, or Courtney White. You may also visit our visit our website.

Ohio License Renewal Date is Fast Approaching!

Ohio RNs and APRNs must renew their licenses not later than October 31, 2019 to continue to practice nursing in Ohio.

The Ohio Board of Nursing’s website indicates that 213,527 licenses have been renewed.

Ohio RNs and APRNs should not delay renewing! If you are an Ohio RN or APRN and you do not renew by October 31, 2019, your license will lapse and you cannot work as a nurse on a lapsed license. Applying for reinstatement of your license is required which takes additional time to process. Working as a nurse on a lapsed license is also disciplinable offense.

Ohio APRNs must renew BOTH their RN and APRN licenses. These are two separate applications and both applications must be completed.

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 is also required.

In certain cases, the Renewal Application may be forwarded to the Ohio Board of Nursing Compliance Unit for review and an Ohio Board of Nursing 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 an Ohio Board of Nursing investigator, or signing a Consent Agreement.

As always, if you have a question about this post or the Ohio Board of Nursing in general, please feel free to contact Todd Collis at (614) 628-6962 or todd.collis@dinsmore.com or Beth Collis at (614) 628-6945 or beth.collis@dinsmore.com.

Use of Social Media by Nurses in Ohio

The Ohio Board of Nursing’s (“OBN”) Fall 2018 edition of Momentum Magazine includes an interesting article concerning the use by nurses of social media.  The article addresses the American Nurses Association’s (“ANA”) Principles for Social Networking and the NurseSee: https://www.nursingworld.org/~4af4f2/globalassets/docs/ana/ethics/social-networking.pdf.

Although the ANA Principles provide useful guidance concerning the use by nurses of social media, nurses licensed in Ohio are required to observe the OBN’s laws and rules concerning use of social media which include, but are not limited to, the following:

OAC 4723-4-03(H) and 4723-4-04(H): These are OBN rules which provide in part that registered nurses and practical nurses licensed in Ohio shall not disseminate patient information for purposes other than patient care, or for otherwise fulfilling the nurse’s assigned job responsibilities, through social media, texting, emailing or any other form of communication.

These rules prohibit nurses licensed in Ohio from using social media, texting, emailing or any other form of communication to disseminate patient information for purposes other than patient care, or for otherwise fulfilling the nurse’s assigned job responsibilities.

OAC 4723-4-06(Q): This is an OBN rule which provides that, for purposes of OBN rules OAC 4723-4-06(I), (J), (K), (L), and (M), a nurse shall not use social media, texting, emailing, or other forms of communication with, or about a patient, for non-health care purposes or for purposes other than fulfilling the nurse’s assigned job responsibilities.

This rule prohibits a nurse licensed in Ohio from using social media, texting, emailing, or other forms of communication with, or about a patient, for non-health care purposes or for purposes other than fulfilling the nurse’s assigned job responsibilities, for purposes of the OBN’s requirements that a nurse licensed in Ohio:

-maintain professional boundaries;

-provide patient privacy and courtesy;

-not engage in behavior that causes, may cause, or may reasonably be interpreted as, physical, verbal, mental, or emotional abuse;

-not misappropriate a patient’s property;

-not engage in behavior for, or that may reasonably be interpreted as behavior for, personal gain at a patient’s expense;

-not engage in inappropriate involvement in, or that may reasonably be interpreted as inappropriate involvement in, a patient’s personal relationships or financial matters;

-not engage in sexual conduct with a patient;

-not engage in conduct in the course of practice that may reasonably be interpreted as sexual; and

-not engage in any verbal behavior that is, or may reasonably be interpreted as, seductive or sexually demeaning to a patient.

A nurse licensed in Ohio who is determined by the OBN to have failed to comply with any of these rules based on the improper use of social media, texting, emailing, or any other form of communication is subject to disciplinary action by the OBN.

As noted in the OBN article, “The use of social media carries with it much responsibility.  Please be aware of your responsibilities and professional obligations and how its use may impact you.”

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.

Ohio Nurses with Narcotic Restrictions: You CANNOT Observe Waste

A nurse who is the subject of a disciplinary action by the Ohio Board of Nursing may, in certain instances, have one or more restrictions placed on their nursing license.  One type of restriction is a narcotics restriction.

Although the language of a narcotic restriction can and does vary depending on the facts and circumstances of each case, the Ohio Board of Nursing’s narcotic restriction typically provides:

“Unless otherwise approved in advance, in writing, by the board or its’ designee, NURSE shall not administer, have access to, or possess (except as prescribed for NURSE’s use by another so authorized by law who has received a complete copy of this Consent Agreement prior to prescribing for NURSE) any narcotics, other controlled substances, or mood-altering drugs in which NURSE is working in a position that requires a nursing license. In addition, NURSE shall not possess or carry any work keys for locked medication carts, cabinets, drawers, or containers. NURSE shall not count narcotics. NURSE shall not call in or order prescription refills for narcotics, other controlled substances, or mood-altering drugs.”

As stated noted above, a nurse with a narcotics restriction may not count narcotics.  Counting narcotics includes, but is not limited to, observing the waste of unused narcotics by another nurse because observing waste is considered part of the counting process.  If you have a narcotics restriction on your license, you may not observe waste and you should ensure that your employer is aware that your narcotic restriction prohibits you from observing waste before you are in a situation where you are asked to witness another nurse wasting.

Narcotic restrictions can be permanent or temporary.  If the narcotic restriction is permanent, the nurse must comply with the narcotic restriction on a permanent basis, unless the narcotic restriction includes the language, “Unless otherwise approved in advance, in writing, by the board or is designee”.  This language permits the nurse to request the Nursing Board’s approval for a specific exception to the permanent narcotic restriction.

If the narcotic restriction is temporary, the nurse must comply with the narcotic restriction during their entire probationary period or, in certain cases, for a shorter period.  If the temporary narcotic restriction includes the language, “Unless otherwise approved in advance, in writing, by the board or its’ designee”, the nurse may request the Nursing Board’s approval for a specific exception to the temporary narcotic restriction.

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