Chapter 4723-6 Alternative Program for Chemical Dependency/Substance Use Disorder Monitoring

4723-6-01 Definitions.

As used in this chapter:

(A) "Agreement" means a voluntary, written contract between an individual and the board's alternative program for chemical dependency in which the board abstains from taking disciplinary action against the individual for violation of Chapter 4723. of the Revised Code and the individual agrees to be monitored by the board according to the terms and conditions of the program specified in section 4723.35 of the Revised Code, this chapter, and any other terms and conditions determined necessary by the program to ensure that the individual is able to practice in accordance with acceptable standards of safe care.

(B) "Approved treatment program" means an alcoholism or drug treatment program which is either certified by the appropriate state agency or is accredited by the "Joint Commission on Accreditation of Health Care Organizations" or JCAHO.

(C) "Chemical dependency" means either of the following:

(1) The chronic and habitual use of alcoholic beverages to the extent that the user no longer can control the use of alcohol; or the user's health, safety, or welfare or that of others is endangered; or

(2) The use of a drug of abuse, to the extent that the user becomes physically or psychologically dependent on the drug; or the user's health, safety, or welfare or that of others is endangered.

For purposes of section 4723.35 of the Revised Code and Chapter 4723-6 of the Administrative Code, the term "chemical dependency" includes or may otherwise be referred to as a "substance use disorder" to the extent the disorder involves dependency and not abuse.

(D) "Drug of abuse" has the same meaning as in section 3719.011 of the Revised Code, and includes any controlled substance as defined in section 3719.01 of the Revised Code, any harmful intoxicant as defined in section 2925.01 of the Revised Code, or any dangerous drug as defined in section 4729.01 of the Revised Code.

(E) "Person" includes, without limitation, a natural person, a corporation, whether nonprofit or for profit, a partnership, a limited liability company, an unincorporated society or association, or two or more persons having a joint or common interest.

(F) "Practitioner" means a healthcare professional who is authorized by law to prescribe drugs, dangerous drugs, or drug therapy related devices in the course of the professional's practice and is licensed under Chapter 4715., 4723., 4725., 4731., or 4730., of the Revised Code and authorized by law to write prescription's for drugs or dangerous drugs.

(G) "Program" means the unit of the board responsible for administering the alternative program for chemical dependency established by section 4723.35 of the Revised Code.

(H) "Random alcohol and drug screen" means a laboratory or breathalyzer test administered at an irregular interval not known in advance by the individual to be tested to detect the presence of alcohol, drugs of abuse, or other mood altering substances in the individual's body fluids, breath, hair, or nails.

(I) "Support group" means individuals who hold licenses or certificates issued under Chapter 4723. of the Revised Code who meet regularly to discuss practice issues related to recovery and to provide substance use disorder support for its members.

(J) "Treatment provider" means a licensed healthcare provider, with demonstrated expertise in substance use disorder, who providesalcoholism or drug treatment in an approved treatment program to an individual participating in the alternative program for chemical dependency.

(K) "Twelve-step meeting" means a meeting sponsored by a group such as alcoholics anonymous, narcotics anonymous, or a related organization which addresses substance use disorders and promotes sobriety and recovery through peer group support, self-help, and anonymity, and which is based on an abstinence model of recovery.

Effective: 02/01/2014
R.C. 119.032 review dates: 10/17/2013 and 10/15/2018
Promulgated Under: 119.03
Statutory Authority: 4723.07 , 4723.35
Rule Amplifies: 4723.35
Prior Effective Dates: 04/01/1997, 04/01/1998, 04/01/1999, 02/01/2001, 02/01/2003, 02/01/2004, 02/01/2009

4723-6-02 Eligibility requirements for participation in the alternative program for chemical dependency.

(A) An individual may participate in the program if the board supervising member for disciplinary matters determines that all of the following conditions are met:

(1) The individual holds a current, valid license to practice nursing as either a registered nurse or a licensed practical nurse in Ohio, or a current, valid certificate or intern certificate to practice as a dialysis technician or community health worker in Ohio;

(2) The individual requests and the board provides the individual a program application, which includes temporary license or surrender form, located at http://www.nursing.ohio.gov/forms.htm (revised 2008). Within ten business days of the date the application was mailed by the board to the individual, the individual submits a completed voluntary temporary license or certificate surrender form to the board;

(3) The individual submits to the program a completed program application within sixty days of the date the application was mailed by the board to the individual. The completed application shall be accompanied by all of the following:

(a) A substance use disorder assessment that:

(i) Includes a bio-psycho-social evaluation performed by a licensed healthcare provider with demonstrated expertise in the treatment of substance use disorders; and

(ii) Documents a diagnosis of substance use disorder and sets forth an organized plan for treatment.

(b) Signed waivers giving the program consent to receive and release information necessary for purposes of determining program eligibility. This includes, but is not limited to, information to and from employers, probation officers, law enforcement agencies, peer assistance programs, and any treatment providers or health care practitioners. No person with knowledge of any information disclosed by the program pursuant to this paragraph shall divulge the information to any other person. The information contained in the completed application shall indicate to the board supervising member for disciplinary matters all of the following:

(i) The individual may be effectively treated for the substance use disorder;

(ii) The individual may be effectively monitored for compliance with program requirements; and

(iii) The individual is not subject to the prohibitions in paragraph (B) of this rule.

(B) An individual may not participate in the program if the board receives information indicating that the individual's compliance with the program may not be effectively monitored while participating in the program. This information includes, but is not limited to, the following:

(1) The individual is currently using or being prescribed a drug of abuse, as defined in paragraph (D) of rule 4723-6-01 of the Administrative Code;

(2) The individual has a medical and/or psychiatric condition, diagnosis, or disorder, other than a substance use disorder, in which the manifest symptoms are not adequately controlled;

(3) The individual has attempted or completed two or more substance use disorder treatment programs as of the date of the application, not including the individual's current substance use disorder treatment plan and related treatment currently submitted for purposes of program eligibility;

(4) The individual has substituted or tampered with a substance or drug of abuse;

(5) The board has taken action against the individual's license to practice nursing as either a registered nurse or a licensed practical nurse in Ohio or certificate or intern certificate to practice as a dialysis technician or community health worker in Ohio;

(6) A board regulating nurses, dialysis technicians or community health workers in another jurisdiction has taken action against the individual's license to practice nursing as either a registered nurse or a licensed practical nurse in that jurisdiction or certificate or intern certificate to practice as a dialysis technician or community health worker in that jurisdiction;

(7) The individual has completed the program or a similar program in another jurisdiction;

(8) The individual has been terminated from the program or from a similar program in another jurisdiction;

(9) The individual was admitted to, but did not complete or is no longer in good standing, a similar program in another jurisdiction;

(10) The individual has been convicted of, pled guilty to (other than a plea resulting in a finding of eligibility for intervention in lieu of conviction), had a judicial finding of eligibility for diversion for, or had a judicial finding of guilt resulting from a plea of no contest to any felony or an act in another jurisdiction that would constitute a felony in Ohio;

(11) The board determines that the public may not be adequately protected from unsafe practice if the individual enters the program; or

(12) The individual has failed or refused to cooperate with a board investigation.

Effective: 02/01/2014
R.C. 119.032 review dates: 10/17/2013 and 10/15/2018
Promulgated Under: 119.03
Statutory Authority: 4723.07 , 4723.35
Rule Amplifies: 4723.35
Prior Effective Dates: 04/01/1997, 04/01/1999, 02/01/2001, 02/01/2003, 02/01/2004, 02/01/2009

4723-6-03 Terms and conditions a participant must meet to successfully complete the alternative program for chemical dependency.

(A) The participant shall enter into an agreement with the program and shall comply with all of the terms and conditions of the participant's agreement for the time period specified in the agreement.

(B) The agreement may include the following:

(1) A requirement that the participant:

(a) Enter substance use disorder treatment in an approved treatment program no later than thirty days from the execution of the agreement; and

(b) Comply with all requirements of the participant's substance use disorder treatment plan;

(2) A requirement that the participant cause the treatment provider to submit documentation acceptable to the program of the participant's compliance with the participant's chemical dependency treatment plan;

(3) A requirement that the participant abstain from the use of alcohol, drugs of abuse, and controlled substances, except for the participant's time limited use of drugs of abuse and controlled substances prescribed by the participant's treating practitioner with knowledge of the participant's substance use disorder and treatment plan ;

(4) A requirement that the participant cause all treating healthcare providers who authorize, prescribe or administer medication with respect to the participant, including but not limited to drugs of abuse, to submit documentation regarding the medication to the program, in the manner specified in the agreement;

(5) A requirement that the participant, when using medications according to paragraphs (B)(3) and (B)(4) of this rule, cease working in any position that requires a nursing license or dialysis technician certificate or intern certificate, or as a certified community health worker.

(6) A requirement that the participant inform any and all treating healthcare practitioners of the participant's substance use disorder and recovery status prior to receiving treatment and prescriptions;

(7) A requirement that the participant cause any and all healthcare practitioners, substance use disorder treatment providers, and counselors to provide progress reports to the program at the intervals specified in the participant's agreement;

(8) A requirement that the participant submit to random alcohol and drug screens when requested by the program, and that the participant comply with all requirements of random alcohol and drug screening as specified in the agreement;

(9) A requirement that the participant attend support , peer group, or twelve-step group meetings as specified in the participant's agreement, and that the participant verify attendance at these meetings by signature of a group leader or meeting representative and submit such signatures to the program using the meeting form provided by the program;

(10) A requirement that the participant comply with the employment restrictions specified by the participant's participatory agreement and terms and conditions of employment as executed at the time of employment approval by the program. The restrictions may include, but are not limited to:

(a) Work schedule restrictions;

(b) Work site supervision restrictions, such as work site monitors;

(c) Restrictions against administering and having access to alcohol or products containing alcohol, excluding topically applied alcohol-based products used for disinfection purposes, controlled substances, and drugs of abuse; and

(d) Practice setting or client restrictions;

(11) A requirement that the participant sign waivers required by division (E) of section 4723.35 of the Revised Code, and that the participant also sign waivers permitting the program to receive or release information necessary to properly facilitate the monitoring of the participant's progress in their recovery from substance use disorder and their compliance with their program requirements. The information may be released to or received from persons, including, but not limited to, employers, probation officers, law enforcement agencies, peer assistance programs, substance use disorder treatment providers, healthcare practitioners, government agencies, or court officials. No person with knowledge of any information disclosed by the program pursuant to this paragraph shall divulge the information to any other person.

(12) A requirement that the participant return to employment in a position that requires a nursing license or dialysis technician certificate or intern certificate, or as a community health worker, while under the terms of the agreement, and continue in that employment, or other employment requiring licensure or certification, for an aggregate period of at least one year of full-time employment, prior to being considered for release from the terms and conditions of the agreement;

(13) A requirement that the participant be responsible for all costs to the participant resulting from the participant's program requirements. All costs incurred by the participant resulting from the participant's participation in the program are wholly between the participant and any person providing the services according to the program requirements. None of the costs incurred by the participant shall be charged to the program and the program assumes no liability for any costs incurred by the participant in paying all costs;

(14) A requirement that the participant submit a written personal report to the program at the intervals specified by the participant's agreement;

(15) A requirement that the participant meet in person with a program representative at the intervals specified by the participant's agreement;

(16) A requirement that the participant obey all federal, state, and local laws and rules including, but not limited to, all laws and rules regulating the practice of nursing or dialysis care in Ohio; and

(17) A requirement that the participant comply with all requirements specified in the participant's agreement that the program determines are necessary to ensure effective monitoring of the participant's compliance with program requirements and that the public is adequately protected from unsafe practice.

Effective: 02/01/2014
R.C. 119.032 review dates: 10/17/2013 and 10/15/2018
Promulgated Under: 119.03
Statutory Authority: 4723.07 , 4723.35
Rule Amplifies: 4723.35
Prior Effective Dates: 04/01/1997, 04/01/1999, 02/01/2001, 02/01/2003, 02/01/2004, 02/01/2009

4723-6-04 Successful completion of the alternative program for chemical dependency.

(A) A participant successfully completes the program when the participant complies with the terms and conditions of the program specified in section 4723.35 of the Revised Code, this chapter, and the participant's agreement for the time period specified in the agreement.

(B) When a participant successfully completes the program as indicated in paragraph (A) of this rule, the program shall notify the participant of such successful completion in writing. Once the participant receives this written notification of successful completion from the program, the participant shall no longer be required to comply with the terms and conditions of the program specified in section 4723.35 of the Revised Code, this chapter, and the participant's agreement.

(C) When making a decision regarding disciplinary action for violations of Chapter 4723. of the Revised Code or the rules of the board, the board will be notified by a written communication from board staff, marked as confidential according to division (F) of section 4723.35 of the Revised Code, if the individual who is the subject of proposed board action previously successfully completed the program.

(D) A participant who successfully completes the program shall not be reported to the national council of state boards of nursing's disciplinary data bank or the federally mandated healthcare integrity and protection data bank unless the board imposes disciplinary action against the participant.

Effective: 02/01/2014
R.C. 119.032 review dates: 10/17/2013 and 10/15/2018
Promulgated Under: 119.03
Statutory Authority: 4723.07 , 4723.35
Rule Amplifies: 4723.35
Prior Effective Dates: 04/01/1997, 04/01/1999, 02/01/2001, 02/01/2003, 02/01/2004, 02/01/2009

4723-6-05 Causes for termination from the alternative program for chemical dependency.

Participation in the program may be terminated for any of the following reasons:

(A) The participant fails to comply with any of the terms and conditions of the program specified in section 4723.35 of the Revised Code and this chapter;

(B) The participant fails to comply with any provision of the participant's agreement;

(C) The participant is unable to practice according to acceptable and prevailing standards of safe care; or

(D) The program receives information which, after investigation, indicates that the participant may have committed an additional violation of a provision of Chapter 4723. of the Revised Code or any rules of the board.

R.C. 119.032 review dates: 10/17/2013 and 10/17/2018
Promulgated Under: 119.03
Statutory Authority: 4723.07 , 4723.35
Rule Amplifies: 4723.35
Prior Effective Dates: 10/16/2008, 10/01/2013, 02/01/2009

4723-6-06 Confidentiality regarding the alternative program for chemical dependency.

(A) Admission and ongoing monitoring shall be conducted in a manner that maintains the confidentiality of the individual.

(B) According to division (F)(3) of section 4723.35 of the Revised Code, all records regarding an individual's application to or participation in the program are confidential and are not public records. The records include, but are not limited to:

(1) Medical records;

(2) Substance use disorder records;

(3) Mental health records;

(4) Treatment records;

(5) Reports required by the participant's agreement;

(6) Waivers and releases required by the participant's agreement;

(7) Alcohol and drug screen results;

(8) Verification of attendance at support, peer group or twelve-step meetings; and

(9) Internal program documentation concerning participants in the program, including program assessments and recommendations ;

(10) Applications submitted to the program, records related to review of program eligibility, and participant agreements.

(C) According to division (E)(4) of section 4723.35 of the Revised Code, a participant may authorize in writing the release of information regarding his or her progress in the program.

(D) All program records shall be maintained in a secure storage area for a period of two years following the participant's date of successful completion of the program, or for a period of two years following a determination that an applicant is not eligible for participation.

Effective: 02/01/2014
R.C. 119.032 review dates: 10/17/2013 and 10/15/2018
Promulgated Under: 119.03
Statutory Authority: 4723.07 , 4723.35
Rule Amplifies: 4723.35
Prior Effective Dates: 04/01/1997, 04/01/1999, 02/01/2001, 02/01/2009