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.

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 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.

REMINDER – Ohio Licensed Practical Nurses: Renew Your Nursing License Now

Reminder to all LPNs: Renewal of Ohio licensed practical nurse (“LPN”) licenses began on July 1, 2018 and ends on October 31, 2018.  At this time, you have less than a week left to renew your license.

It is a disciplinable offense to engage in the practice of nursing having failed to renew a nursing license.  An Ohio LPN license which is not renewed will lapse on November 1, 2018.  An Ohio LPN whose nursing license has lapsed is not authorized to work as a nurse until their nursing license is reinstated by the Ohio Board of Nursing.

The renewal fee is $65.00, plus a $3.50 transaction fee.  A late processing fee goes into effect on September 16, 2018.  An Ohio LPN who renews their nursing license on or after September 16, 2018 must pay an additional $50.00.  Fees must be paid online at the time of renewal with a credit or debit card (Master Card, VISA or Discover), or pre-paid card.  The renewal application will not be processed until all required fees are submitted.  All fees are non-refundable.

The renewal application includes, but is not limited to, questions concerning criminal, licensure, mental health matters, 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 LPN to obtain additional information.  In other cases, a Consent Agreement may be offered to the LPN to resolve a disciplinable offense instead of preceding to an administrative hearing.

If you do not understand a question in your LPN 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 LPN renewal application, speaking with an Ohio Board of Nursing investigator, or signing a Consent Agreement. Feel free to contact on of the attorneys at Collis Law Group LLC at (614) 486-3909 if you would like to schedule an appointment for a consultation for assistance to complete the renewal application.

For additional renewal application information from the Ohio Board of Nursing, see: http://www.nursing.ohio.gov/PDFS/Licensure/Renewal/Renewal_Momentum.pdf

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.

Nurses who enter into a Consent Agreement with the Ohio Board of Nursing MUST complete all conditions OR negotiate terms to modify to the Agreement.

A Consent Agreement with the Ohio Board of Nursing is a negotiated contract between the nurse and the Board that specifies the terms and conditions under which a nurse on probation may continue to practice as a nurse and/or seek reinstatement of their license, if suspended. By signing the Consent Agreement, the nurse agrees (among other things) to waive their right to a hearing and to comply with the terms in the Consent Agreement.

Failure to comply with the terms of the Consent Agreement can result in the Nursing Board automatically suspending a nurse’s license to practice in Ohio.

Typically, a Consent Agreement which includes a suspension will outline conditions for a nurse to seek reinstatement of their license or, for a Consent Agreement that includes probation, will place conditions on a nurse’s license. Often, nurses are subjected to random drug testing, are required to attend weekly AA/NA meetings, or complete additional continuing education courses. In some cases, a nurse may have a license limitation that does not allow them to work in certain settings or dispense medications.

Actions including, but not limited to, missing a mental health or chemical dependency examination, failure to check in daily for alcohol or drug screens, or failure to submit to a screen when selected are a few examples of a breach of the Consent Agreement.

Even when unemployed as a nurse, the nurse is still required to comply with the Consent Agreement. For Consent Agreements that include a probationary period, the nurse must actually work in a nursing position for the probation period to count down.

Compliance with a Consent Agreement can be time-consuming and costly. Nurses are often unable to afford the random screens or become frustrated with the lengthy probationary period, especially if they are not working as a nurse.

I am often contacted by nurses who want to stop compliance with the terms of their Consent Agreement because they can no longer afford the random screens or are no longer interested in completing all compliance terms.

A Consent Agreement is a negotiated contract between a nurse and the Nursing Board.  The nurse MUST negotiate alternative terms in writing with the Nursing Board. If the nurse simply stops complying with the Consent Agreement, without first negotiating a written amendment or modification to the Consent Agreement, their license will likely be automatically suspended by the Nursing Board for failure to comply with the Consent Agreement.

To seek an amendment or modification to the Consent Agreement, the nurse must be in full compliance with all probationary terms. Even if in full compliance, the Nursing Board may only agree to place the nurse’s license on indefinite suspension. And if the nurse wants to seek reinstatement of their license in the future, the nurse may be required to complete most if not all of the probationary terms again.

In summary, in order to cease having to comply with the terms and conditions of a Consent Agreement, the nurse must re-negotiate the terms of the Consent Agreement with the Nursing Board and must continue to comply with their Consent Agreement until the Nursing Board agrees in writing to the modified Consent Agreement.

All Consent Agreements must be approved by the full Board, which only meets six times a year. The nurse should expect that it could take up to 8 weeks before the Nursing Board will approve a new Consent Agreement or a modification to a Consent Agreement.  The nurse must continue to comply with their existing Consent Agreement until a new Consent Agreement or modification has been approved in writing by the Nursing Board.

Before making the decision on whether to stop complying with the terms of a Consent Agreement with the Board of Nursing, it is recommended to consult with an attorney. Factors such as the nurse’s financial condition and their desire to practice nursing in the future should be considered.

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.

 

Nurses: Marijuana is still Illegal in Ohio, and a Positive Drug Screen could lead to Discipline

Marijuana for medical or recreational purposes is now legal in some states, such as Colorado and Oregon. However, use of marijuana is still illegal in Ohio. If employed as a nurse, you can be subjected to pre-employment, for cause, or random drug tests. If you test positive for marijuana, you may be terminated from your job and may be subjected to discipline by the Ohio Board of Nursing. Chemicals in marijuana, mainly THC, can show on a urine, blood, saliva or hair follicle drug test after 120 or more days, based on usage and other personal factors. (See Samhsa.gov for guidance on drug testing).

According to RC 4723.28(B)(8), it is a disciplinable offense for a nurse to be self-administering or otherwise taking into the body any dangerous drug, as defined in RC 4729.01, in any way that is not in accordance with a legal, valid prescription issued for that individual, or self-administering or otherwise taking into the body any drug that is a Schedule I controlled substance. (Marijuana is defined as a Schedule I substance.)

Courts have held that an employee is not protected from a wrongful discharge even if they are lawfully taking medical marijuana, and test positive at work. (Coats v. Dish Network). This is because marijuana is unlawful under Federal Law, which the court determined prevails in this situation.

The Ohio Board of Nursing routinely takes disciplinary action against a nurse who tests positive for marijuana, even in cases where the nurse has consumed marijuana in a legal jurisdiction. Therefore, it is important for Ohio nurses to be aware of the risks they take if consuming marijuana, whether it be legally or illegally. Testing positive on a drug screen may result in a disciplinary action against your nursing license.

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.

 

What to Consider When Hiring an Attorney

When facing a disciplinary action before your state licensing board or when looking for assistance in applying for a license, it is important to find the right attorney to help you through this often cumbersome process. To make an informed decision, you should set an appointment and meet with the attorney in person to gauge the following:

Experience/Expertise: Experience in representing nurses before the Ohio Board of Nursing is a very important factor to consider. It is your professional license that is at stake. While you may have a good friend who is an attorney or a good professional relationship with a criminal defense counsel, often they do not have the experience or expertise to handle your defense before the Ohio Board of Nursing. In addition, many attorneys will claim to represent licensees before your licensing board. However, you should ask them what percentage of their practice is in the area of licensure defense. You also want to determine how many cases they have taken through the hearing process and on appeal. You don’t want your case to be the first case they have taken to a board hearing.

Personality/Compatibility/Accessibility: Meet and interview the attorney before you decide to hire them. Do they seem knowledgeable about the investigative or disciplinary process? Did they take the time to meet with you, answer your questions and explain the disciplinary process to you? Do you think the attorney understands your individual circumstances? Do you feel welcome to pick up the phone or to email the attorney with questions and concerns?

Costs/Accounting of fees: You should have a frank discussion with your attorney and make sure you understand their fees and how the fees are to be paid. Does the firm take credit cards? Do they charge late fees or interest on late balances? Does the firm send you a monthly statement that outlines the time spent on your case that month and any fees/expenses charged to you? If you deposit money in the firm’s IOLTA trust account are you sent a monthly accounting of your money on retainer? Before entering into any relationship with an attorney you should have a clear understanding of their fees and should receive a regular accounting of any fees or expenses for which you will be charged.

As always, if you have any questions, please feel free to contact me at: beth@collislaw.com