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.

Important Changes to the Ohio Board of Nursing – First Source Screening Program

If you are being monitored by the Ohio Board of Nursing and required to submit random screens through First Source, changes have been made to the program that will affect every participant. You will no longer be able to use the app or call the toll-free number to check whether you have been selected to test.

Effective Sept. 1, 2021, there will be changes to First Source screening procedures. Updated information will be posted on the Board’s website  and First Source will send a communication to participants.

The check-in portal and process will change. All participants will have access and be required to use the new FSSolutions portal.

Enrollment in the new system was required by Aug. 13, 2021. If you have not done so, contact the FSSolutions team at 833-476-1173 during business hours or e-mail at RMS@fssolutions.com.

It is important to note this new system requires you to log in through the website (participant.fssolutions.com) for your check-in message, rather than calling the toll-free number or using the mobile app.

If you have questions about the changes to the screening program, immediately contact your compliance agent (monitor) at the Nursing Board.

As always, if you have questions about the Ohio Board of Nursing or the disciplinary monitoring program, you may contact attorneys Beth Collis or Todd Collis at the law firm of Dinsmore and Shohl, LLP at beth.collis@dinsmore.com or todd.collis@dinsmore.com.

Ohio’s Fresh Start Act Creates a Path to Professional Licensure for those with Prior Convictions

Featured

In January 2021, Ohio Governor Mike DeWine signed House Bill 263, better known as the Fresh Start Act (the Act), into law. The Act standardizes the professional licensure process in Ohio by removing vague disqualifiers such as “moral turpitude” and “lack of moral character.” Through its restorative justice approach, the Act offers professionals with records of certain prior offenses a path to licensure. Most of the Act’s provisions become effective on Oct. 9, 2021, which is also the deadline for state licensing authorities to submit a new list of disqualifying offenses.

The Act impacts a number of professions, including but not limited to physicians, nurses, dentists, chiropractors, and pharmacists. Under the new law, licensing boards are prohibited from rejecting an individual’s application for initial licensure for any of the following reasons:

-Solely or in part on a conviction of, judicial finding of guilt of, or plea of guilty to an offense;

-A criminal charge that does not result in a conviction, judicial finding of guilt, or plea of guilty;

-A nonspecific qualification, such as “moral turpitude” or lack of “moral character”;

-A disqualifying offense included on the authority’s list of specific offenses the authority must adopt under the Act, if consideration of that offense occurs after the time periods allowed under the Act.

The Act does not apply to license renewals. However, convictions, guilty pleas, or findings of guilt must be considered under the Act before refusing a license renewal.

Ohio licensing authorities are required to establish a list of “disqualifying offenses” by Oct. 9, 2021. The list of disqualifying offenses must be made publicly available on the licensing authority’s website. Licensing authorities may only include offenses that are directly related to the licensed occupation’s duties and responsibilities. When reviewing an application for licensure, the Act allows licensing authorities to use a preponderance of the evidence standard when weighing factors such as the nature and seriousness of the offense, the time passed since the offense was committed, the relationship of the offense to the individual’s ability to perform job duties, mitigating factors such as rehabilitation and treatment, and public safety concerns.

Disqualified applicants must be notified of the specific grounds for being refused licensure, their rights to an administrative hearing, and the earliest date they can reapply. In any administrative hearing reviewing the licensing authority’s decision, the licensing authority bears the burden of proving the disqualifying offense directly relates to the occupation.

Furthermore, the Act restricts the amount of time an offense may be considered as part of the applicant’s submission.

If you have questions about Ohio’s Fresh Start Act or are seeking professional licensure in your state, please contact Todd Collis at (614) 628-6962 or todd.collis@dinsmore.com.

*Ashley Durner is a summer associate at Dinsmore & Shohl, LLP, and is not licensed to practice law. Mr. Collis thanks Ms. Durner for her assistance with the preparation of this article.

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.