About Collis Law

The attorneys at the Collis Law Group, LLC defend professionals before the State Medical Board of Ohio, Ohio Board of Nursing and other licensing boards.

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.

 

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Registered Nurses: Don’t Let Your License Lapse

Under RC 4723.24, if a nursing license is not timely renewed, the license lapses on the first day of November of the renewal year. Registered nurses must renew their licenses on odd-numbered years. Therefore, if you do not renew your RN license by October 31, 2017, it will lapse. Practicing nursing on a lapsed license is a disciplinable offense.

After you file your license renewal, it is recommended that you verify before October 31, 2017 that your license has been renewed by the Nursing Board. Verify your license renewal at: http://elicense.ohio.gov/.

RC 4723.03(A) provides that no person may practice as a registered nurse, represent themselves as being a registered nurse, or use the title “registered nurse”, the initials “R.N.”, or any other title implying that the person is a registered nurse, for a fee, salary, or other consideration without holding a current, valid license.

RC 4723.28(B)(2) provides that the Board of Nursing may discipline a nurse if they engage in the practice of nursing, having failed to renew a 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.

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

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

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

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

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

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

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

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

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

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

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

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

 

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

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

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

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

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

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

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

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

 

Ohio RNs – License Renewal Time!

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

 Cost and Timing:

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

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

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

Questions on the RN Renewal Application:

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

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

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

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

Ohio Nurses: Failure to Document May Result in Disciplinary Action Against Your Nursing License

The importance of documentation in the nursing field cannot be underestimated.

The Ohio Board of Nursing is authorized to discipline a licensee for (among other things) failure to practice in accordance with acceptable and prevailing standards of safe nursing care.  Failure to document the administration or otherwise account for the disposition of controlled substances that the Nurse removed from the Pyxis, or other place where controlled substances are stored, may also be the basis for the Nursing Board to discipline a nurse.

In certain cases, the Nursing Board will offer the Nurse a Consent Agreement as an alternative to an Administrative Hearing.  A Consent Agreement allows the Nurse to avoid the time, worry, and expense of an Administrative Hearing.  Nurses do not need to sign a Consent Agreement. It is always a good practice to read a proposed Consent Agreement very carefully.  We have seen Consent Agreements that are based on allegations of failure to document the administration or otherwise account for the disposition of controlled substances. In many cases, the Consent Agreement requires  (in some cases, lasting years)  random drug screening, narcotic restrictions, and practice restrictions, even when there was no history of drug use or abuse by the Nurse.

If the nurse does not sign a proposed Consent Agreement, he or she always has the right to go to an Administrative Hearing.  The nurse can present evidence that there is no history of drug use or abuse and that the nurse has an otherwise excellent history of employment.  The Board’s attorney is going to present its evidence that the nurse failed to document the administration or otherwise account for the disposition of controlled substances that were removed.

It is imperative to completely, accurately, and timely document the administration or disposition (waste) of controlled substances or other drugs! The Nursing Board may place a nurse on probation and subject them to multiple probationary terms, even if there is no evidence that they suffer from chemical dependency and even if there is no evidence of diversion.

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.

 

 

 

ADVANCED PRACTICE REGISTERED NURSES: New Legislation to take Effect on April 4, 2017

On January 4, 2017, Governor Kasich signed Ohio Substitute House Bill 216 into law.

Effective April 4, 2017, there will be new licensing criteria for advanced practice registered nurses (APRNs).  A new APRN license will replace the current “Certificate  of  Authority” and “Certificate  to Prescribe”.

The APRN license will also authorize a Certified Nurse-Midwife (CNM), a Certified Nurse Practitioner (CNP), and a Certified Nurse Specialist (CNS) to prescribe.  In order to obtain the new APRN license, CNPs, CNSs, and CNMs must have either a current Certificate to Prescribe or Certificate to Prescribe Externship, or have completed a 45-hour course in advanced pharmacology within five years of the application date.

Additional information is available from the Ohio Association of Advanced Practice Nurses here: http://c.ymcdn.com/sites/www.oaapn.org/resource/resmgr/hb_216/HB_216_Signed_Revised_-_Effe.pdf

A FAQ from the Ohio Association of Advanced Practice Nurses is here: https://oaapn.site-ym.com/page/HBFAQ

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.