Chapter 4723-6 Alternative Program for Chemically Dependent Nurses

4723-6-01 Definitions.

As used in this chapter:

(A) "Agreement" means a voluntary, written contract between an individual and the alternative program for chemical dependency stipulating the individual's consent to comply with 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 pursuant to Chapter 4723. of the Revised Code 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.

(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.

(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 the following:

(1) A person who is licensed pursuant to Chapter 4715., 4731., or 4741., of the Revised Code and authorized by law to write prescriptions for drugs or dangerous drugs; or

(2) A clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner who holds a certificate to prescribe drugs and therapeutic devices in collaboration with one or more physicians or podiatrists in accordance with section 4723.48 of the Revised Code.

(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, or hair.

(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 chemical dependency support for its members.

(J) "Treatment provider" means the person rendering alcoholism 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 chemical dependency issues and promotes a philosophy of peer group support, self-help, and anonymity, and is based on an abstinence model of recovery.

Effective: 02/01/2009
R.C. 119.032 review dates: 10/16/2008 and 10/01/2013
Promulgated Under: 119.03
Statutory Authority: 4723.07, 4723.35
Rule Amplifies: 4723.35
Prior Effective Dates: 4/1/1997, 4/1/1998, 4/1/1999, 2/1/2001, 2/1/2003, 2/1/2004

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 temporary certificate to practice as a dialysis technician or community health worker in Ohio;

(2) The individual requests or obtains from the board a program application. Within ten business days of the date the application was mailed by the board to the individual, the individual submits to the program a completed voluntary temporary license or certificate surrender form accompanied by the individual's license or certificate;

(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 chemical dependency assessment that:

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

(ii) Documents a diagnosis of chemical dependency and sets forth an organized plan for chemical dependency 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 chemical dependency;

(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 chemical dependency, in which the manifest symptoms are not adequately controlled;

(3) The individual has attempted or completed two or more chemical dependency treatment programs as of the date of the application, notwithstanding the individual's current chemical dependency 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 temporary 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 temporary 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) Conviction of, a plea of guilty to, a plea of guilty to notwithstanding a guilty plea resulting in intervention in lieu or treatment in lieu of conviction, a judicial finding of guilt of, or 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.

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 chemical dependency 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 chemical dependency treatment plan;

(2) A requirement that the participant cause the provision of 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, excepting participant's time limited use of alcohol, drugs of abuse and controlled substances in accordance with a treatment plan established for the participant by a qualified prescriber;

(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 form and manner specified in the agreement;

(5) A requirement that the participant, when using medications in accordance with paragraphs (B)(3) and (B)(4) of this rule, cease working in any position that requires a nursing license or dialysis technician 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 chemical dependency and recovery status prior to receiving treatment and prescriptions;

(7) A requirement that the participant cause any and all healthcare practitioners, chemical dependency 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 consumable alcohol, 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 chemical dependency 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, chemical dependency 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 that requires a nursing license or dialysis technician certificate, or as a community health worker, while under the terms 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 in accordance with 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 any and all requirements specified in the participant's agreement which 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.

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 if the participant 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: 02/01/2009
Promulgated Under: 119.03
Statutory Authority: 4723.07, 4723.35
Rule Amplifies: 4723.35
Prior Effective Dates: 4/1/1997, 4/1/1999, 2/1/2001, 2/1/2003, 2/1/2004

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;

(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.

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) In accordance with division (E)(3) of section 4723.35 of the Revised Code, all records regarding an individual participating in the program are confidential. The records include, but are not limited to:

(1) Medical records;

(2) Chemical dependency 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.

(C) In accordance with 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.