Ohio nurses: Watch when your Certificate to Prescribe Externship (CTP-E) and CTP expire!

As a registered nurse in Ohio, it has become routine to timely submit a complete RN renewal application at the same time every two years. However, a CTP-E is issued for one year and expires one year from the date of issuance, NOT one year after you start working as a nurse. In addition, once a CTP is issued, the renewal date may be different from the date the nurse renews their license. It is imperative that you know when you need to renew your license, CTP-E and CTP.  You will not receive a letter or notification from the Nursing Board to remind you to renew your certificate to prescribe.  It is illegal to continue to prescribe on a lapsed CTP-E or CTP!

The Ohio Board of Nursing requires advanced practice nurses who have had no prior experience prescribing medications or therapeutic devices to obtain a Certificate to Prescribe-Externship (“CTP-E”).  The purpose of the externship is to create a period during which the nurse’s prescribing activities are reviewed and evaluated by a supervising professional for the purpose of ongoing improvement of the nurse’s competence, knowledge, and skill in pharmacokinetic principles and the application of these principles to the nurse’s area of practice.

In order to apply for a CTP-E, the applicant must hold a valid Ohio R.N. license as well as a current Certificate of Authority to practice as a certified nurse midwife, nurse practitioner or nurse specialist.  In addition, the applicant must have completed required coursework on advanced pharmacology.  Once all materials have been submitted and reviewed by the Board of Nursing, the CTP-E will be issued for one year.  The year begins on the date the CTP-E is issued by the Board.  It is critical to remember this date.

During this year, the advanced practice nurse is required to complete 1,500 hours of supervised prescribing (500 hours under the direct supervision of a supervising professional).  Direct supervision means that the supervising professional is on-site when the nurse is prescribing.  300 of the 500 direct supervision hours must be supervised by a physician; the remaining 200 hours may, with the collaborating physician’s permission, be supervised by an advanced practice nurse with prescriptive authority, not a CTP-E.  The remaining 1,000 hours may be indirectly supervised.  This means that a physician, in accordance with a schedule documented in the standard care arrangement, regularly and timely reviews the nurse’s prescriptions and prescribing practices.

Once the advanced practice nurse has completed the required supervision hours through the CTP-E, the supervision must be documented by the collaborating physician and submitted directly to the Board of Nursing on Form B.  PLEASE NOTE that Form B must be submitted well prior to the end of the expiration date on the CTP-E to allow the Board time to review it and issue the advanced practice nurse applicant a Certificate to Prescribe.  Even if Form B is submitted timely, it is illegal to continue to prescribe after the year for the CTP-E has expired unless the nurse has received the Certificate to Prescribe.  Advanced practice nurses may face discipline if they continue to prescribe once the CTP-E has expired if they have not been issued a Certificate to Prescribe.

A CTP-E cannot be renewed.  It can be extended for a one-time period of 2 years, if a request to extend is timely received by the Board before the CTP-E expires.

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

OHIO LPNs – It is time to renew your license to practice nursing in Ohio!

According to the Ohio Board of Nursing’s website, starting on July 1, 2016, all Ohio LPNs will be able to renew their professional license online.

Important renewal information from the Nursing Board is located at: http://www.nursing.ohio.gov/PDFS/2Renewal_Momentum.pdf

Often, nurses have questions about how to respond to certain questions on the Renewal Application and what information needs to be provided to the Nursing Board in the Renewal Application.

Nurses are required to provide the Nursing Board with truthful and accurate information on their Renewal Applications.  Failure to do so can lead to discipline by the Nursing Board.

Additional Information May Be Required  (from Ohio Board of Nursing website)
• If you are asked to provide court documents or other information that may be required as part of your application, please be prepared to upload the documents electronically through the online system.  This information is usually required of applicants who answer “yes” to one of the additional information questions on the renewal application.  
• No hardcopies of court documents or other information required as part of your application will be accepted. Waiting until a deadline and then realizing you do not have all the information and in the form needed to upload the documents electronically through the online system will prevent you from renewing. 
• Incomplete renewal applications will not be accepted by the system.  If all required documents are not provided electronically, the renewal application is incomplete.

If you have questions concerning how to respond to questions in your Renewal Application, what information you need to include, and/or what Court documents you need to include with your Renewal Application, it is recommended that you obtain experienced legal counsel to help you complete your Renewal Application.

The attorneys at the Collis Law Group offer a 1-2 hour consultation to meet with a nurse, review all relevant Court documents, and assist the nurse prepare any necessary or required  response to a question on a Renewal Application.  In most cases, we offer this consultation for as low as a flat fee of $500.00.  Feel free to contact one of the attorneys at the Collis Law Group at 614-486-3909 to schedule a Renewal Application consultation.

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 the Collis Law Group by phone at 614-486-3909.  For more information about the Nursing Board, please feel free to visit our website at www.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.

 

What To Look for in a Defense Attorney

I am always surprised to hear from nurses that they hired a lawyer who is not responsive to phone calls or emails in a timely manner, confused the nurse’s matter with other clients, failed to keep the nurse informed of the status of their matter, or failed to provide the nurse with a monthly accounting of legal fees and expenses. However, I am most surprised to hear from nurses who tell me that they hired a lawyer who they do not feel comfortable confiding in.

I am often asked what skills, qualifications, and qualities a nurse should look for when selecting legal representation for a matter involving the Ohio Board of Nursing (or any other State licensing Board).  Because Administrative Law is a rather unique area of the law, it is important to consider the following:

Not All Cases Are The Same: It is important to select defense counsel who you feel comfortable confiding in, and who recognizes that each matter is different and can present to the Board the unique circumstances of your particular matter with passion and commitment.

Understanding: An attorney who understands and presents your matter to the Board in a clear and coherent manner is also an important aspect of the representation.

Responsiveness: Selecting an attorney who is responsive to your phone calls and emails, and who timely communicates with you concerning important information about your matter is critical to the client-counsel relationship.

Sound Legal Advice: An attorney who provides sensible options based on their knowledge of nursing laws and rules and administrative law procedure, is an essential element to the handling of your matter.

Experience: Hiring an attorney who has handled multiple matters before your licensing Board from the initial investigation through the administrative hearing process is of paramount consideration.

When selecting legal counsel for your Ohio Board of Nursing matter, please remember the acronym N-U-R-S-E.

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 LLC at 614-486-3909 or email me at beth@collislaw.com.

 

 

Ohio Board of Nursing Alternative Program: Underutilized by the Ohio Board of Nursing and Often a Bad Option for Nurses

Many nurses who realize they have a chemical dependency problem consider applying for the Ohio Board of Nursing’s Alternative Program for Chemical Dependency. The Alternative Program is a program designed as an alternative to public discipline for the Board to monitor nurses who suffer from chemical dependency issues who want to obtain treatment.

The Alternative Program could be an excellent option for nurses who know they need treatment in which to obtain treatment and not have it publically registered as “discipline” on their Ohio license. However, nurses should be aware of the following:

Limited Eligibility

Ohio Administrative Code 4723-6-02(B) prohibits a nurse from participating in the Alternative Program if the Board determines that the nurse’s compliance cannot be effectively monitored. This rule also specifies at least 12 different reasons why the Board can refuse to permit a nurse to participate in the Alternative Program.

Limited Admission

As of June 30, 2014, there were only 73 active cases in the Alternative Program (source: June 30, 2014 Nursing Board Annual Report). In Fiscal Year 2014, the Board reported that it mailed out 41 applications, received 32 completed applications, and admitted only 14 applicants.

License Inactivation

Most nurses are not aware that to even be considered for admission to the Alternative Program, they must inactivate their nursing licenses. Unfortunately, being denied admission to the Alternative Program does not automatically reactivate the nurse’s license. Instead, the nurse must request that his or her license be reactivated, a process for which there is also no timeline imposed on the Board. In our practice, we have seen nurses wait for months after having been denied admission to the Alternative Program before the Board re-activates their license.

Application Process

Alternative Program applicants must also complete a rigorous application detailing their chemical dependency history, including diagnoses and treatment, relapses, and related agency or law enforcement involvement. In addition, the applicant must undergo a complete chemical dependency evaluation and authorize the disclosure of all records related to the evaluation to the Board. There is no timeline imposed upon the Board for deciding whether to admit an applicant to the Alternative Program. Many applicants are denied admission without explanation.

Limited Confidentiality

In our experience, if a nurse is denied entry into the Alternative Program or is terminated from the Alternative Program, the Board uses the information that the nurse disclosed to the Board in the Alternative Program application to form the basis of a public disciplinary action against the nurse. Although the Alternative Program is described as a confidential program, there are limits to this confidentiality and many nurses are unaware of these limitations.

Rigorous Requirements

Based on the Alternative Program agreements we have reviewed, the Board imposes rigorous requirements on the nurse participating in the Alternative Program, including but not limited to monitoring periods sometimes in excess of monitoring periods we have seen in public disciplinary matters.

Conclusion 

Prior to even requesting an Alternative Program Application from the Ohio Board of Nursing, consider obtaining the advice of experienced legal counsel to help you determine how best to proceed in your case.

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 Collis Law Group, LLC at 614-486-3909. You may also look for more information at http://www.collislaw.com.

Death and dying, from a nurse’s perspective

Since a close relative of mine passed away a little over a year ago, I have been fascinated with reading stories and articles related to end of life issues. So often in America, death and dying is a taboo subject that everyone dances around and which no one seems to be willing to openly and honestly discuss. As we are all going to die one day, I find it rather amazing that people really don’t want to discuss it.

Because I regularly represent nurses who are seeking initial licensure or are the subject of an investigation by the Ohio Board of Nursing, I was curious to see what type of training nurses receive related to end of life issues and how nurses deal with the death of their patients.

I recently came upon two books by a nurse, Theresa Brown, who is an oncology nurse from Pittsburgh, who addresses death and dying from a nurse’s perspective. In her recent book, The Shift, Brown follows the lives of four cancer patients over a 12 hour shift. Brown raises many important issues related to providing nursing care to patients in their homes, listening to patients and family members deal with their fears, and helping her patients deal with the inevitable future.

In her previous book, Critical Care, A New Nurse faces Death, Life and Everything in Between, Brown highlights her first year as a nurse. This book has been used by many nursing schools as part of their curriculum.

A story highlighting Brown and her books can be found on NPR at:

http://www.npr.org/sections/health-shots/2015/09/28/443468965/a-nurse-reflects-on-the-privilege-of-caring-for-dying-patients

I highly encourage all nurses (and others interested in end of life issues) to listen to the NPR story and consider reading Brown’s books or other literature on end of life issues.

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

When the Ohio Board of Nursing can automatically suspend a license

The Nurse Practice Act in the State of Ohio (R.C. 4723) sets out certain instances when the Nursing Board can take a disciplinary action against a nurse. In most instances, the Nursing Board will issue a Notice of Opportunity for Hearing to the nurse that addresses the allegations against the nurse, note the Code section that the nurse is alleged to have violated, and offer the nurse an opportunity to request a hearing prior to the Nursing Board issuing any sanction against a nurse.

However, in instances when the Nursing Board believes that allowing the nurse to continue to practice presents danger of “immediate and serious harm to the public,” the Nursing Board can suspend the license prior to offering the nurse a hearing. In previous blog posts, I have noted instances when a nurse has been convicted of a serious crime (aggravated murder, murder, gross sexual imposition, etc.) in which the Nursing Board automatically suspended a license prior to offering the nurse a hearing.

The Nursing Board has automatically suspended a nursing license prior to offering the nurse a hearing though in less seriously instances. For example, if a nurse is under probation with the Nursing Board and subject to terms in an Adjudication Order or Consent Agreement and violates any terms of the Agreement the Nursing Board will automatically suspended their nursing license prior to offering them a hearing. Violations of Consent Agreements (such as testing positive on a random drug test or failing to notify the Nursing Board of their employment) has triggered an automatically suspension.

Once the license has been automatically suspended, the nurse can request a hearing and present evidence in their defense. However, during the hearing process or while negotiating terms of an Amended Consent Agreement, the nurse’s license remains suspended. It is imperative when entering into any Consent Agreement with the Nursing Board that the nurse understands the terms of the Consent Agreement, because failure to comply with the terms, limitations or conditions of the Consent Agreement can result in an automatic suspension of their nursing license.

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 the Collis Law Group at 614-486-3909 or email me at beth@collislaw.com.

You have a right to counsel when meeting with a Nursing Board investigator

The role of the Ohio Board of Nursing is to regulate the practice of nursing. This entails issuing professional licenses to nurses and also investigating and imposing discipline on nurses who violate the Ohio Nurse Practice Act.

Often, a nurse first learns that a complaint has been filed against them with the Nursing Board when they are contacted by a Nursing Board investigator. The Nursing Board has “field” investigators who work throughout Ohio and are each assigned to various geographic regions of the State.  Once a complaint has been filed or initialed against a nurse, an investigator is assigned to conduct the investigation. This may include collecting records from the nurse’s employer or from the Court. It may also include contacting the nurse for a personal interview.

Prior to meeting with the Nursing Board investigator, please understand that under Ohio law, (R.C. 9.84) you have the right to be accompanied, represented and advised by an attorney and you are also required to be advised of the right to counsel BEFORE you are interrogated.

Unlike in a criminal proceeding, you will not be assigned legal counsel for your defense. You are required to seek your own legal counsel to assist in your defense before the Nursing Board or any other administrative agency. However, you have a right to have counsel present.

Many nurses have asked me whether they “look guilty” by attending the meeting with legal counsel or if it “appears that they are hiding something” if they take legal counsel with them to the meeting. Nothing could be farther from the truth. Meetings with investigators can be intimidating, overwhelming and threatening. Any information that is obtained by the investigator can and will be used against you before the Nursing Board. In addition, if the investigator believes that the nurse’s conduct violates the law, they can also alert the local sheriff’s department or criminal Prosecutor, and in certain instances, criminal charges can be issued against a nurse.

While I often encourage nurses to fully cooperate in an investigation, including meeting with the investigator, I highly encourage nurses to retain legal counsel to assist them throughout the investigative and disciplinary process. You have a right to counsel under Ohio law and it is in your interest to exercise this right to protect yourself.

As always, if you have any questions about this post or the Ohio Board of Nursing in general, please contact one of the attorneys at the law firm of Collis, Smiles and Collis, LLC at 614-486-3909 or you may 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.