This website publishes administrative rules on their effective dates, as designated by the adopting state agencies, colleges, and
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| Rule |
Rule 4731-16-01 | Definitions.
Effective:
January 31, 2009
As used in this chapter of the Administrative Code: (A) "Impairment" means impairment of ability to practice according to acceptable and prevailing standards of care because of habitual or excessive use or abuse of drugs, alcohol, or other substances that impair ability to practice. Impairment includes inability to practice in accordance with such standards, and inability to practice in accordance with such standards without appropriate treatment, monitoring or supervision. (B) "Relapse" means any use of, or obtaining for the purpose of using, alcohol or a drug or substance that may impair ability to practice, by someone who has received a diagnosis of and treatment for chemical dependency or abuse, except pursuant to the directions of a treating physician who has knowledge of the patient's history and of the disease of addiction, or pursuant to the direction of a physician in a medical emergency. An instance of use that occurs during detoxification treatment or inpatient or residential treatment before a practitioner's disease of addiction has been brought into remission does not constitute a relapse. (C) "Approved treatment provider" means a treatment provider approved pursuant to section 4731.25 of the Revised Code and this chapter of the Administrative Code. (D) "The board" means the state medical board of Ohio. (E) "Sobriety" means abstinence from alcohol, and from drugs or substances that may impair ability to practice, except pursuant to the directions of a treating physician who has knowledge of the patient's history and of the disease of addiction, or pursuant to the direction of a physician in a medical emergency. (F) "Order" for a controlled substance or other drug means a preprinted order or standing order as defined in rule 4729-5-01 of the Administrative Code. (G) "Impaired physician committee" includes health committees, physician assistance committees, peer support committees, and similar bodies. (H) "Massage therapist or cosmetic therapist" means a person who holds or has applied for a certificate to practice massage therapy or cosmetic therapy, or both, and who does not currently hold or have a pending application for any other certificate issued by the board.
Last updated August 31, 2023 at 2:09 PM
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Rule 4731-16-02 | General procedures in impairment cases.
Effective:
January 31, 2022
(A) Should the board have reason to
believe that any licensee or applicant suffers from impairment, as that term is
used in division (B)(5) of section 4730.25 of the Revised Code, division
(B)(26) of section 4731.22 of the Revised Code, division (A)(18) of section
4759.07 of the Revised Code, division (B)(6) of section 4760.13 of the Revised
Code, division (A)(18) of section 4761.09 of the Revised Code, division (B)(6)
of section 4762.13 of the Revised Code, division (B)(6) of section 4774.13 of
the Revised Code, or division (B)(6) of section 4778.14 of the Revised Code, it
may compel the individual to submit to a mental or physical examination, or
both. (1) Such examinations
shall be undertaken by an approved treatment provider designated by the
board. (2) The notice issued
ordering the individual to submit to examination shall delineate acts, conduct
or behavior committed or displayed which establish reason to believe that the
individual is impaired. (3) Failure to submit to
examination ordered by the board constitutes an admission of impairment unless
the failure is due to circumstances beyond the individual's
control. (B) In cases where the only disciplinary
action initiated against the individual is for violation of division (B)(5) of
section 4730.25 of the Revised Code, division (B)(26) of section 4731.22 of the
Revised Code, division (A)(18) of section 4759.07 of the Revised Code, division
(B)(6) of section 4760.13 of the Revised Code, division (A)(18) of section
4761.09 of the Revised Code, division (B)(6) of section 4762.13 of the Revised
Code, division (B)(6) of section 4774.13 of the Revised Code, or division
(B)(6) of section 4778.14 of the Revised Code, the following general pattern of
action shall be followed: (1) Upon identification
by the board of reason to believe that a licensee or applicant is impaired it
may compel an examination or examinations as set forth in paragraph (A) of this
rule. The examination must meet all requirements of rule 4731-16-05 of the
Administrative Code. (a) If the examination or examinations fail to disclose
impairment, no action shall be initiated pursuant to division (B)(5) of section
4730.25 of the Revised Code, division (B)(26) of section 4731.22 of the Revised
Code, division (A)(18) of section 4759.07 of the Revised Code, division (B)(6)
of section 4760.13 of the Revised Code, division (A)(18) of section 4761.09 of
the Revised Code, division (B)(6) of section 4762.13 of the Revised Code,
division (B)(6) of section 4774.13 of the Revised Code, or division (B)(6) of
section 4778.14 of the Revised Code unless other investigation produces
reliable, substantial, and probative evidence demonstrating
impairment. (b) If the examination or examinations disclose impairment,
or if the board has other reliable, substantial and probative evidence
demonstrating impairment, the board shall initiate proceedings to suspend the
license or deny the applicant. The board may issue an order of summary
suspension as provided in division (G) of section 4730.25 of the Revised Code,
division (G) of section 4731.22 of the Revised Code, division (G) of section
4759.07 of the Revised Code, division (G) of section 4760.13 of the Revised
Code, division (G) of section 4761.09 of the Revised Code, division (G) of
section 4762.13 of the Revised Code, division (G) of section 4774.13 of the
Revised Code, or division (G) of section 4778.14 of the Revised
Code. (2) The presence of one
or more of the following circumstances shall constitute independent proof of
impairment and shall support license suspension or denial without the need for
an examination: (a) The individual has relapsed during or following
treatment; (b) The individual has applied for or requested treatment
in lieu of conviction of a criminal charge or intervention in lieu of
conviction of a criminal charge, or has applied for or requested entry into a
similar diversion or drug intervention program; (c) The individual has pled guilty to or has had a judicial
finding of guilt of a criminal offense that involved the individual's
personal use or abuse of any controlled substance. (3) Before being eligible
to apply for reinstatement of a license suspended under this paragraph the
impaired individual must demonstrate to the board that the individual can
resume practice in compliance with acceptable and prevailing standards of care
under the provisions of the individual's license. Such demonstrations
shall include but shall not be limited to the following: (a) Certification from a treatment provider approved under
section 4731.25 of the Revised Code that the individual has successfully
completed all required treatment, as follows: (i) Except as provided in
paragraph (B)(3)(a)(ii) of this rule, the required treatment shall include
inpatient or residential treatment that extends a minimum of twenty-eight days
with the following exception: If the individual has previously completed an
inpatient or residential treatment program of at least twenty-eight days and
maintained sobriety for at least one year following completion of that
inpatient or residential treatment, the treatment required shall be determined
by the treatment provider. (ii) If the impaired
individual is a massage therapist, dietitian, respiratory care professional,
radiologist assistant, or genetic counselor who does not meet the criteria set
forth in paragraph (B)(3)(a)(iii) of this rule, the required treatment shall
include intensive outpatient treatment meeting the requirements of paragraph
(A)(13) of rule 4731-16-08 of the Administrative Code. The required intensive
outpatient treatment must include a minimum of twenty treatment sessions over
no less than five consecutive weeks with the following exception: If the
massage therapist, dietitian, respiratory care professional, radiologist
assistant, or genetic counselor has previously completed an intensive
outpatient treatment program of at least twenty treatment sessions over no less
than five consecutive weeks and has maintained sobriety for at least one year
following completion of that intensive outpatient treatment, the treatment
required shall be determined by the treatment provider. (iii) If the impaired
individual is a massage therapist, dietitian, respiratory care professional,
radiologist assistant, or genetic counselor who was investigated by the board
for possible impairment as part of a previous application for or while holding
any license issued by the board other than a license to practice massage
therapy, dietetics, respiratory care, as a radiologist assistant, or as a
genetic counselor, the required treatment shall be in compliance with paragraph
(B)(3)(a)(i) of this rule. (b) Evidence of continuing full compliance with an
aftercare contract that meets the requirements of rule 4731-16-10 of the
Administrative Code, and with any consent agreement or order of the board then
in effect; (c) Two written reports indicating that the
individual's ability to practice has been assessed and that the individual
has been found capable of practicing according to acceptable and prevailing
standards of care. The reports shall be made by individuals or providers
approved by the board for making such assessments and shall describe the basis
for this determination. A physician who is the medical director of a treatment
provider approved under section 4731.25 of the Revised Code and this chapter of
the Administrative Code may perform such an assessment without prior board
approval. (4) Subject to the
provisions of paragraph (D) of this rule, the board may reinstate a license
suspended under this paragraph after the demonstration described in paragraph
(B)(3) of this rule and after the individual has entered into a written consent
agreement which conforms to the requirements set forth in rule 4731-16-06 of
the Administrative Code, or after the board has issued a final order in lieu of
a consent agreement. (5) When the impaired
individual resumes practice after license reinstatement, the board shall
require continued monitoring of the individual. This monitoring shall include
but not be limited to compliance with the written consent agreement entered
into before reinstatement or compliance with conditions imposed by board order
after a hearing, and, upon termination of the consent agreement, submission by
the individual to the board, for at least two years, of annual written progress
reports made under penalty of perjury stating whether the license holder has
maintained sobriety. (C) In cases where the board has
initiated a disciplinary action for violations of any provisions of Chapter
4731., Chapter 4730., Chapter 4759., Chapter 4760., Chapter 4761., Chapter
4762., Chapter 4774., or Chapter 4778. of the Revised Code or any of its rules
in addition to division (B)(5) of section 4730.25 of the Revised Code, division
(B)(26) of section 4731.22 of the Revised Code, division (A)(18) of section
4759.07 or the Revised Code, division (B)(6) of section 4760.13 of the Revised
Code, division (A)(18) of section 4761.09 of the Revised Code, division (B)(6)
of section 4762.13 of the Revised Code, division (B)(6) of section 4774.13, or
division (B)(6) of section 4778.14 of the Revised Code, the general pattern of
action described in paragraph (B) of this rule will be followed with the
following exceptions: (1) If the board
permanently revokes a license, the individual shall not be eligible for further
consideration for licensure or license reinstatement; (2) If the board imposes
a period of ineligibility for licensure, the individual shall not be eligible
for licensure or license reinstatement until the period of ineligibility has
lapsed; (3) If the board imposes
an indefinite period of ineligibility, licensure or license reinstatement shall
depend upon successful completion of the requirements in paragraphs (B)(3) and
(B)(4) of this rule and determination by the board that the period of
suspension or ineligibility served is commensurate with the violations
found. (D) Except as provided in this paragraph,
an individual who has relapsed during or following treatment shall be
ineligible to apply for reinstatement for at least ninety days following the
date of license suspension for a first relapse, for at least one year following
the date of license suspension for a second relapse, and for at least three
years following the date of license suspension for a third relapse. An
individual who suffers a relapse, as that term is defined in paragraph (B) of
rule 4731-16-01 of the Administrative Code, will not be subjected to suspension
or other board discipline based on that relapse if all of the following
conditions are met: (1) The relapse was the
first ever suffered by the individual; (2) The relapse occurred
under circumstances that the board finds minimized the probability that the
individual would either provide patient care while under influence of alcohol
or drugs or leave patients without necessary care while under the influence of
alcohol or drugs; (3) The relapse involved
a single occasion of use for less than one day; (4) The individual
self-reported the relapse within forty-eight hours in accordance with rule
4731-15-01 of the Administrative Code; (5) The individual does
not thereafter suffer another relapse; (6) The board does not
obtain evidence of acts, conduct or omissions that would support the imposition
of discipline, apart from the relapse itself; (7) The relapse does not
lead to the individual being charged with any criminal offense; (8) The individual
reported the relapse to an approved treatment provider within forty-eight
hours, submitted to evaluation as requested by the approved treatment provider,
and obtained any additional treatment recommended; (9) The individual
suspended practice until the approved treatment provider reported in writing to
the board that it had made a clear determination that the individual was
capable of practicing according to acceptable and prevailing standards of care;
and (10) The approved
treatment provider provides the board a full report of the evaluation, and the
board's secretary and supervising member decide that there are not
circumstances warranting the initiation of disciplinary action.
Last updated August 31, 2023 at 2:09 PM
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Rule 4731-16-04 | Other violations.
Effective:
November 30, 2002
For purposes of board disciplinary action for violations of any board rule or any provision of Chapter 4731., Chapter 4730., Chapter 4760. or Chapter 4762. of the Revised Code other than division (B)(26) of section 4731.22 of the Revised Code, division (B)(5) of section 4730.25 of the Revised Code, division (B)(6) of section 4760.13 of the Revised Code or division (B)(6) of section 4762.13 of the Revised Code, impairment shall not excuse acts which result in conviction or which might, as determined by the board, have an adverse impact on other individuals. Such acts shall constitute independent basis for disciplinary action.
Last updated August 31, 2023 at 2:09 PM
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Rule 4731-16-05 | Examinations.
Effective:
January 31, 2022
(A) Any examination ordered by the board
under division (F)(2) of section 4730.25 of the Revised Code, division (B)(26)
of section 4731.22 of the Revised Code, division (F) of section 4759.07 of the
Revised Code, division (F)(2) of section 4760.13 of the Revised Code, division
(F) of section 4761.09 of the Revised Code, division (F)(2) of section 4762.13
of the Revised Code, division (F)(2) of section 4774.13 of the Revised Code, or
division (F)(2) of section 4778.14 of the Revised Code in order to determine
impairment, or any examination of an applicant for or a holder of a certificate
issued under Chapter 4730., Chapter 4731., Chapter 4759., Chapter 4760.,
Chapter 4761., Chapter 4762., Chapter 4774., or Chapter 4778. of the Revised
Code performed by an approved treatment provider shall include all of the
following: (1) Urine, hair or blood
toxicology testing, or any combination, with legal chain of custody and
forensic capability protocol; (2) Comprehensive
evaluation pertinent to the reasons for referral, including: (a) Complete medical history and physical
examination; (b) Routine laboratory tests, to include complete blood
count and liver function studies; (c) Psychiatric evaluation, except as in paragraph
(A)(3)(b)(ii) of this rule; (d) Comprehensive biopsychosocial assessment; (e) Corroborating interviews of at least two persons who
are close to the individual; (f) Administration of at least two clinically approved
substance use disorder assessment tools; and (3) One of the following
assessment standards, as applicable: (a) Except as provided in paragraph (A)(3)(b) of this rule,
observation of the individual in an inpatient setting for at least seventy-two
consecutive hours, unless the approved treatment provider diagnoses the
individual as chemically dependent and formulates a treatment plan in a shorter
time period. (b) If the individual is a massage therapist, dietitian,
respiratory care professional, radiologist assistant, or genetic counselor who
does not meet the criteria set forth in paragraph (A)(3)(c) of this
rule: (i) Outpatient assessment
that meets the requirements of paragraphs (A)(1) and (A)(2) of this
rule; (ii) Any other requirements as identified by the board or
treatment provider. Psychiatric evaluation is not required in an examination
administered under this paragraph unless the need for such an evaluation is
identified by the board of the treatment provider. (c) If the individual is a massage therapist, dietitian,
respiratory care professional, radiologist assistant, or genetic counselor who
was investigated by the board for possible impairment as part of a previous
application for or while holding any certificate issued by the board,
observation of the individual in an inpatient setting for at least seventy-two
consecutive hours, unless the approved treatment provider diagnoses the
individual as chemically dependent and formulates a treatment plan in a shorter
time period. (B) A diagnosis made by an approved
treatment provider based on an examination ordered by the board under division
(F)(2) of section 4730.25 of the Revised Code, division (B)(26) of section
4731.22 of the Revised Code, division (F) of section 4759.07 of the Revised
Code, division (F)(2) of section 4760.13 of the Revised Code, division (F) of
section 4761.09 of the Revised Code, division (F)(2) of section 4762.13 of the
Revised Code, division (F)(2) of section 4774.13 of the Revised Code, or
division (G)(2) of section 4778.14 of the Revised Code shall be made solely for
the purpose of providing evidence for use by the board. A licensee or applicant
who undergoes an examination ordered by the board but who refuses to authorize
the treatment provider to release reports or information to the board shall be
deemed to have failed to submit to the examination due to circumstances within
the individual's control, and a default and final order may be entered
without the taking of testimony or presentation of evidence as provided in
division (F)(2) of section 4730.25 of the Revised Code, division (B)(26) of
section 4731.22 of the Revised Code, division (F) of section 4759.07 of the
Revised Code, division (F)(2) of section 4760.13 of the Revised Code, division
(F) of section 4761.09 of the Revised Code, division (F)(2) of section 4762.13
of the Revised Code, division (F)(2) of section 4774.13 of the Revised Code, or
division (F)(2) of section 4778.14 of the Revised Code. (C) The report issued pursuant to an
examination ordered by the board shall be submitted to the board within five
days following completion of the examination. (D) The board may require the certificate
holder or applicant to submit to a drug toxicology screen at the time it serves
its order to submit to an examination or at any time after it issues the
examination order and before the examination is completed. (1) The drug toxicology
screen shall be considered part of the examination. (2) Refusal to submit to
the drug toxicology screen immediately upon such request shall constitute
failure to submit to a mental or physical examination ordered by the board and
shall constitute an admission of the allegations against the individual, unless
the failure is due to circumstances beyond the individual's control. A
default and final order may be entered without the taking of testimony or
presentation of evidence. (E) An individual ordered by the board to
an examination who refuses to authorize the treatment provider to contact any
person identified by the treatment provider as being appropriate for the
purpose of conducting a corroborating interview as part of the examination
shall be deemed to have failed to submit to the examination due to
circumstances within the individual's control, and a default and final
order may be entered into without the taking of testimony or presentation of
evidence.
Last updated August 31, 2023 at 2:09 PM
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Rule 4731-16-06 | Consent agreements and orders for reinstatement of impaired practitioners.
(A) The written consent agreement required under division (F)(2) of section 4730.25 of the Revised Code, division (B)(26) of section 4731.22 of the Revised Code, division (F)(2) of section 4760.13 of the Revised Code or division (F)(2) of section 4762.13 of the Revised Code and rule 4731-16-02 of the Administrative Code prior to reinstatement of a suspended license, or any board order entered in lieu of a consent agreement, shall require, at a minimum, the following probationary and limiting terms: (1) Obedience of all federal, state, and local laws, and all rules governing practice in Ohio; (2) Submission of quarterly declarations under penalty of perjury stating whether there has been compliance with all conditions of the consent agreement; (3) Periodic appearances before the board or its representatives as requested; (4) Notification to the board of departures or absences from Ohio. Periods of departure or absence shall not reduce the probationary term, unless otherwise determined by motion of the board for absences of three months or longer, or by the secretary or the supervising member of the board for absences of less than three months, in instances where the board can be assured that probationary monitoring is otherwise being performed; (5) Maintenance of a log of all controlled substances, and other drugs as directed by the board, which the practitioner prescribes, orders, personally furnishes, or administers, where appropriate; (6) Prohibition of authority to prescribe, administer, personally furnish , order, or possess controlled substances and, as directed by the board, other substances which may impair ability to practice, where appropriate; (7) Abstinence from the use of alcohol; (8) Abstinence from the use or personal possession of drugs, except those prescribed, administered, or dispensed by another person so authorized by law who has knowledge of the patient's history and of the disease of addiction; (9) Submission of witnessed urine or blood samples upon request of the board, and without prior notice; (10) Undertaking and maintaining participation in a self help support group acceptable to the board, such as alcoholics anonymous or narcotics anonymous, with evidence of compliance to be provided to the board in each quarterly report; (11) Undertaking psychiatric evaluation, and, where appropriate, continuing treatment acceptable to the board, with evidence of compliance to be provided in each quarterly report; (12) Monitoring of progress and status by a physician approved by the board, with reports to be provided to the board quarterly; (13) Prior approval by the board of any practice arrangements or any health care field employment, where appropriate; (14) Copies of the agreement to be provided by the individual to all of the following during the effective period of the agreement or board order: (a) All employers or prospective employers, entities with which the individual contracts or seeks to contract to provide health services or receive training, the chief of staff at each hospital where the individual has or applies for privileges, and all persons and entities that provide the individual chemical dependency treatment or monitoring; and (b) By certified mail, the proper licensing authority of any state or jurisdiction in which the individual holds or applies for any professional license. (15) Contacting an appropriate impaired physicians committee, such as the physician health program, to arrange for assistance in recovery or aftercare; (16) Continuing compliance with the terms of the aftercare contract entered into with the treatment provider, provided, that where terms of the aftercare contract conflict with the terms of the consent agreement or board order, the terms of the consent agreement or board order shall control; (17) Continuing authorization, through appropriate written consent forms, for disclosure by the treatment provider to the board, to treating and monitoring physicians, and to others involved in the monitoring process, of information necessary for them to fulfill their respective duties and obligations; (18) Minimum probationary term of at least five years, except that a practitioner who first applies for licensure or license restoration after receiving treatment for impairment may be given probation of less than five years if the practitioner demonstrates continuous current sobriety of more than one year but less than five years, and a practitioner who first applies for licensure or license restoration after receiving treatment for impairment may be licensed without probation if the practitioner demonstrates continuous current sobriety of at least five years; (19) Periods during which the probationer is not in compliance with all probationary terms, or during which all probationary monitoring provisions have not yet been implemented, as determined by the secretary of the board, shall not reduce the term of probation; (20) No requests by the probationer for modifications to probationary terms for at least one year; and (21) Prohibition of consumption of poppy seeds or any other food or liquid that may produce false results in a toxicology screen. (B) A violation of any term of the consent agreement or board order described in this rule shall constitute grounds to take disciplinary action in accordance with Chapter 119. of the Revised Code.
Last updated August 31, 2023 at 2:09 PM
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Rule 4731-16-07 | Treatment provider program obligations.
(A) In order to hold a certificate of good standing pursuant to this chapter of the Administrative Code, a treatment provider must: (1) Report to the board the name of any practitioner suffering or showing evidence of suffering impairment as described in division (B)(5) of section 4730.25 of the Revised Code, division (B)(26) of section 4731.22 of the Revised Code, division (B)(6) of section 4760.13 of the Revised Code or division (B)(6) of section 4762.13 of the Revised Code who fails to comply within one week with a referral for examination; (2) Report to the board the name of any impaired practitioner who fails to enter treatment within forty-eight hours following the program or provider's determination that the practitioner needs treatment; (3) Require every practitioner who enters treatment to agree to a treatment contract establishing the terms of treatment and aftercare, including any required supervision or restrictions of practice during treatment or aftercare; (4) Require a practitioner to suspend practice upon entry into any required inpatient treatment; (5) Report to the board any failure by an impaired practitioner to comply with the terms of the treatment contract during inpatient or outpatient treatment or aftercare contract during aftercare; (6) Report to the board the resumption of practice of any impaired practitioner before the treatment provider has made a clear determination that the practitioner is capable of practicing according to acceptable and prevailing standards of care; (7) Require that each practitioner who has completed treatment signs an aftercare contract with an approved treatment provider within one week of completion of treatment; (8) Report the identity of any practitioner practicing under the terms of an aftercare contract to hospital administrators, medical chiefs of staff, and chairpersons of impaired physicians committees of all health care institutions at which the practitioner holds clinical privileges. If the practitioner does not hold clinical privileges at any health care institution, the treatment provider shall report the practitioner's identity to the impaired physicians committee of the county medical society, osteopathic academy, or podiatric medical association in every county in which the practitioner practices. If there are no impaired physicians committees in the county, the treatment provider shall report the practitioner's identity to the president or other designated member of the county medical society, osteopathic academy, or podiatric medical association; (9) Report to the board the identity of any practitioner who suffers a relapse; (10) Fulfill all recordkeeping requirements applicable under state and federal laws, including the requirements set forth in paragraphs (C) and (D) of this rule; and (11) In furtherance of paragraphs (A)(5), (A)(6), (A)(8), and (A)(9) of this rule, the treatment provider shall require every practitioner who submits for an evaluation or enters treatment to execute a release with respect to issuance of the reports enumerated therein. (B) The treatment provider shall not report to the board the identity of a practitioner who has been referred for evaluation or treatment by a party other than the board, so long as the practitioner maintains participation in accordance with requirements of section 4731.25 of the Revised Code and the practitioner has not suffered a relapse as defined in rule 4731-16-01 of the Administrative Code. (C) The treatment provider shall complete and maintain records, separate from all other records, containing the following information for each practitioner seen for evaluation or treatment: (1) Date of referral and identity of referral source; (2) Date of admission for evaluation; (3) Date treatment recommendations are made; (4) Date referral source is notified of treatment recommendations; (5) Beginning and ending dates of each treatment phase (e.g. - inpatient, intensive outpatient, extended residential treatment, and aftercare); (6) Dates of all reports made under paragraph (A)(8) of this rule, and identities of individuals to whom made; (7) Dates and sources of information received, if any, indicating there are grounds to believe the practitioner has relapsed during or following aftercare; (8) In the event of the practitioner's refusal to execute appropriate releases under paragraph (B) of this rule, or in the event of revocation of such releases, the date that the referral source is notified that no further information can be given regarding that practitioner under federal law; and (9) In the event the treatment provider is required to report to the board pursuant to one of the provisions of paragraph (A) of this rule, such report shall be made by telephone to the board's executive director or the executive director's designee as soon as practicable, and confirmed by letter mailed within seventy-two hours after the reporting requirement arises. (D) No later than two weeks following the end of each one year period during which the treatment provider has held a certificate of good standing under this chapter of the Administrative Code, the treatment provider shall file with the board a report containing all of the following information for that year: (1) Number of practitioners referred for evaluation; (including self-referrals); (2) Number of practitioners evaluated; (3) Number of referral sources by category (e.g., - self-referrals, board referrals, medical society referrals, referrals by colleagues); (4) Number of practitioner evaluations which resulted in treatment recommendations for chemical dependency; (5) Number of practitioners treated based on the treatment providers own recommendations; (6) Number of practitioners treated based on transfer or referral from other treatment providers; (7) Number of practitioners who entered each phase of treatment; (8) Number of practitioners engaged in each phase of treatment (including those who began treatment in prior years); (9) Number of practitioners who successfully completed each phase of treatment; (10) Number of practitioners discharged from each phase of treatment other than upon successful completion, and the rationale for each such discharge; (11) Number of practitioner relapses identified during aftercare and following aftercare; (12) Number and names of practitioners reported to the board under this chapter of the Administrative Code; and (13) Number and identities of referral sources notified of the treatment provider's inability to release information under federal law.
Last updated August 31, 2023 at 2:09 PM
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Rule 4731-16-08 | Criteria for approval.
Effective:
January 31, 2022
(A) Criteria for approval of treatment
providers shall include all of the following: (1) The philosophy and
individualized treatment plan of the program is based on the disease
concept. (2) The chemical
dependency model of treatment is based on a twelve-step program such as
alcoholics anonymous. (3) The program provides
specialized medical and nursing care during detoxification and appropriate
health care professionals during treatment phase. (4) The evaluation
process is an objective, measurable program which uses tools and testing
procedures to identify patterns, progression, and stages of recovery at
appropriate times in the treatment program. The evaluation shall also emphasize
patient self-assessment. (5) The treatment
provider has a network of referral agencies or professionals which meets the
needs of the practitioner and significant others in the event that the needs go
beyond the program's expertise or available facilities. (6) The treatment
provider has a variety of treatment plan options including inpatient
detoxification treatment, inpatient or residential treatment, and outpatient
services. (7) The involvement and
treatment of family and significant others is provided. (8) The provider gives each patient who
has been diagnosed as in need of treatment a written list of approved treatment
providers from whom indicated inpatient or residential treatment, outpatient
treatment, or aftercare can be obtained. (9) The provider holds certification as
an alcoholism program or drug treatment program by the Ohio department of
alcohol and drug addiction services, or if located outside Ohio, holds
appropriate certification or registration with an agency exercising a similar
function in the state in which it is located. (10) The provider provides advocacy
services only at no cost to the patient, or provides such services only after
obtaining the signature of the patient acknowledging that he or she has been
notified: (a) That advocacy is not treatment; (b) That nothing in Chapter 4730., 4731., 4759., 4760., 4761.,
4762., 4774., or 4778. of the Revised Code or this chapter of the
Administrative Code requires a practitioner to obtain aftercare, monitoring or
advocacy from the provider of inpatient or extended residential treatment or
intensive outpatient treatment, as applicable; and (c) That the practitioner's refusal to obtain aftercare,
monitoring, or advocacy services from the provider of inpatient treatment or
intensive outpatient treatment, as applicable, shall not constitute grounds to
report to the board so long as the practitioner demonstrates that the
practitioner has contracted with another approved treatment provider to receive
any further recommended treatment. (11) The provider has the capability of
making an initial examination to determine what type of treatment an impaired
practitioner requires. (12) The provider requires that each
patient who is subject to the jurisdiction of the board, who is determined to
be impaired, except as provided in paragraph (A)(13) of this rule, complete a
minimum of twenty-eight days of inpatient or residential treatment, or a
combination thereof, during which the patient shall be prohibited by the terms
of the treatment contract from conducting any practice or practice related
activities, and after which the provider shall evaluate the patient and
determine the necessity for further treatment based solely on clinical grounds.
The exceptions in paragraph (C) of this rule notwithstanding, the provider must
personally provide the required inpatient or residential treatment and the
assessment or must confirm that another approved treatment provider has
provided the inpatient or residential treatment and the assessment before
providing any outpatient treatment or aftercare. The inpatient or residential
treatment program must have a continuing inpatient or residential patient
census sufficient to provide an appropriate treatment milieu for patients
receiving treatment in the inpatient or residential setting. This paragraph
shall not apply to a patient who has previously completed an inpatient or
residential treatment program of at least twenty-eight days if the patient was
able to maintain sobriety for at least one year following completion of that
inpatient or residential treatment. (13) The provider
requires that a massage therapist, dietitian, respiratory care professional,
radiologist assistant, or genetic counselor who is determined to be impaired
and who does not meet the criteria set forth in paragraph (A)(14) of this rule,
complete a minimum of twenty treatment sessions over no less than five
consecutive weeks of intensive outpatient treatment, after which the provider
shall evaluate the patient and determine the necessity for further treatment
based solely on clinical grounds. The intensive outpatient treatment must
include: (a) Witnessed toxicology screens with legal chain of custody and
forensic capability performed weekly at therapy sessions; (b) At least three twelve-step meetings weekly; (c) All treatment sessions lasting a minimum of three hours, not
including time spent watching videos or participating in twelve-step
meetings; (d) Family education lasting at least two hours
weekly. (14) The provider requires that a massage
therapist, dietitian, respiratory care professional, radiologist assistant, or
genetic counselor who was investigated by the board for possible impairment as
part of a previous application or while holding any certificate by the board
other than a certificate to practice as a massage therapist, dietitian,
respiratory care professional, radiologist assistant or genetic counselor,
complete the inpatient or residential treatment required in paragraph (A)(12)
of this rule. (15) If the provider did
not hold approval under this chapter prior to January 1, 2001, the provider is
accredited by the joint commission on accreditation of health care
organizations or by CARF (commission on accreditation of rehabilitation
facilities.) (B) A treatment provider which does not
meet the criteria of paragraph (A)(1) or (A)(2) of this rule may nonetheless be
considered for approval if it establishes by evidence acceptable to the board
that its philosophy, individualized treatment plan, or model of treatment is
based on current scientific advances in the field of chemical dependency, and
that its success in treatment is comparable or superior to that obtained by
treatment providers which meet all the criteria of paragraph (A) of this
rule. (C) A treatment provider that does not
meet the criteria of paragraph (A)(3) or (A)(6) of this rule because it does
not offer all phases of treatment may nonetheless be considered for approval if
it meets both of the following requirements. (1) If it does not offer
detoxification treatment, its policies and procedures are structured to assure
that all patients who enter treatment have completed detoxification where
detoxification is medically indicated. (2) If it does not offer
one or more required treatment phases (e.g. - inpatient treatment, intensive
outpatient treatment, or extended residential treatment), it has affiliation
agreements or working relationships with other treatment providers to which
patients can be referred for any necessary treatment it does not
offer.
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Rule 4731-16-09 | Procedures for approval.
(A) Following receipt of a completed application for program approval, an investigation shall be conducted by the board with respect to whether the requirements of this chapter of the Administrative Code have been met. An on-site inspection of the program may be conducted. (B) If the board determines that the treatment provider applying meets the requirements set forth in this chapter of the Administrative Code, it shall issue its certificate of good standing. A certificate of good standing is valid for three years unless suspended or revoked by the board for cause and is valid only for the program approved. It does not cover other programs operated by the owner. Prior to the end of the three-year period, the board will send a renewal application to the treatment provider to be completed and sent back to the board. An on-site visit may be conducted prior to renewal of the certificate. (C) A certificate of good standing is not transferable. (D) The treatment provider shall notify the board of any of the following changes prior to their becoming effective and these changes shall result in reevaluation of any certificate of good standing held by the treatment provider: (1) Transfer of ownership of the program; or (2) Change in location or locations of the program; or (3) Change of directorship. (E) Upon receipt of notice as provided in paragraph (D) of this rule, the board shall forward the appropriate forms in order to initiate review and investigation to determine whether a new certificate of good standing should be issued. An on-site inspection, maintaining program participant confidentiality, may be conducted in the event of a change of program location.
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Rule 4731-16-10 | Aftercare contracts.
(A) Within one week of completing treatment, the practitioner shall enter into an aftercare contract with an approved treatment provider. (B) . The aftercare contract shall include all of the following requirements: (1) Group therapy, support groups, or, when appropriate, an individual counseling, or a combination of the above; (2) Periodic, random, unannounced blood or urine screens, or both; (3) Mandatory participation in alcoholics anonymous, narcotics anonymous, or a similar twelve-step program, or its equivalent; (4) Abstinence from use of alcohol; (5) Abstinence from use of drugs, except those prescribed, administered or personally furnished by another person so authorized by law who has knowledge of the patient's history and of the disease of addiction, or those administered by another person so authorized by law during a medical emergency; (6) Regular contact with a certified alcoholism counselor, or with a physician qualified by training or experience, or both, to treat chemically dependent persons, who assumes responsibility for monitoring defined aspects of aftercare contract compliance, and who agrees to: (a) Report any noncompliance to the treatment provider; and (b) Report any relapse to the treatment provider and the board; (7) A length of contract specified with a minimum of at least two years and at least one hundred and four weekly aftercare sessions, with missed sessions to be made up; (8) Professional therapy, where indicated, to resolve family and work-related problems; (9) Treatment of any ongoing medical problems to be managed by a physician qualified by training or experience, or both, to provide medical care to chemically dependent persons, provided that where such a physician is unavailable due to geographic or other reasonable constraints, treatment shall be managed by a physician in consultation with one so qualified; (10) Referral to other forms of extended care, when indicated; and (11) Any required supervision or restrictions of practice during aftercare.
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Rule 4731-16-11 | Revocation, suspension, or denial of certificate of good standing.
Effective:
September 1, 1999
Promulgated Under:
Ch 119.
(A) The board may refuse to issue or renew, suspend, or revoke a certificate of good standing based upon non-compliance with the provisions of this chapter of the Administrative Code or applicable provisions of Chapter 4731. of the Revised Code. (B) If the board proposes to refuse to issue or renew, suspend, or revoke a certificate of good standing, the applicant or the certificate holder shall be entitled to a hearing on the issue of such proposed denial or such proposed revocation or suspension. Notice and hearing requirements will comply with the provisions of Chapter 119. of the Revised Code and any rules adopted by the board. (C) In determining the effective date of any suspension or revocation of a certificate, the board shall take into consideration those practitioners currently receiving treatment in the treatment program or by the treatment provider subject to the revocation or suspension. (D) If the board refuses to renew, suspends or revokes a certificate of good standing, the treatment provider shall be required to notify those practitioners currently receiving treatment in the treatment program that the certificate of good standing has been suspended or revoked.
Last updated August 31, 2023 at 2:09 PM
Supplemental Information
Authorized By:
–
Amplifies:
–
Five Year Review Date:
Prior Effective Dates:
12/1/1991
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Rule 4731-16-12 | Out-of-state impairment cases.
Effective:
January 31, 2009
(A) If the board orders a certificate holder who neither resides nor physically practices in Ohio to submit to an evaluation under division (B)(26) of section 4731.22 of the Revised Code, division (F)(2) of section 4730.25 of the Revised Code, division (F)(2) of section 4760.13 of the Revised Code or division (F)(2) of section 4762.13 of the Revised Code, or commences disciplinary proceedings against such a certificate holder based on an alleged violation of any of those divisions, the board may waive any or all applicable provisions of this chapter of the Administrative Code, if it finds that alternative means exist to protect the public. Factors the board may consider in determining whether the public will be adequately protected include, but are not limited to, the following: (1) Whether the certificate holder is being monitored by the proper licensing authority in the jurisdiction where the certificate holder resides; (2) Whether the certificate holder has received or is receiving evaluation and treatment from a treatment provider acceptable to the proper licensing authority in the jurisdictions where the certificate holder resides, and whether the treatment provider has agreed to report to the board on the certificate holder's diagnosis and progress in treatment, and to provide the board copies of all reports required to be submitted to the licensing authority in the jurisdiction where the certificate holder resides, if requested by the board; (3) Whether the certificate holder is being monitored by a monitoring or advocacy group acceptable to the proper licensing authority in the jurisdiction where the certificate holder resides; (4) Whether the certificate holder's employer or professional associates are aware of the certificate holder's impairment or alleged impairment. (B) Grant of a waiver or waivers pursuant to this rule shall be conditioned on the certificate holder agreeing by a signed notarized statement to notify the board in writing of any intent to practice medicine or reside in Ohio, to submit to an evaluation by an approved treatment provider at the certificate holder's expense at that time if requested by the board, and to refrain from commencing practice in Ohio without prior board approval. (C) A certificate holder who neither resides nor practices in Ohio who is diagnosed or treated for chemical abuse or chemical dependency outside Ohio must report that diagnosis or treatment in renewing his or her certificate. A certificate holder who neither resides nor practices in Ohio who relapses must report that relapse immediately, as required by rule 4731-15-01 of the Administrative Code. (D) If a certificate holder self-reports diagnosis or treatment as required by paragraph (C) of this rule, the board may forgo disciplinary action if it determines that the certificate holder: (1) Has not been subject to discipline in any other jurisdiction; (2) Is receiving or has completed treatment with a treatment provider acceptable to the medical licensing authority of the jurisdiction in which he or she resides; (3) Has not relapsed; (4) Is participating in or has successfully completed participation in a monitoring program or diversion program acceptable to the medical licensing authority of the jurisdiction in which he or she resides. (E) A certificate holder who neither resides nor practices in Ohio who relocates to Ohio after being diagnosed or treated for chemical abuse or chemical dependency must submit to an evaluation by a treatment provider approved under section 4731.25 of the Revised Code and this chapter of the Administrative Code. (1) If the certificate holder has less than one year documented sobriety at the time of relocation to Ohio, he or she must submit to an evaluation that meets all the requirements of rule 4731-16-05 of the Administrative Code, and must complete two years of aftercare and the applicable treatment as required by paragraph (B)(3) of rule 4731-16-02 of the Administrative Code. (2) If the certificate holder has more than one year but less than five years documented sobriety at the time of relocation to Ohio, he or she must submit to an evaluation that the treatment provider determines to be clinically appropriate, and must obtain the treatment recommended by the treatment provider.
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Rule 4731-16-13 | Duty to report or refer practitioner, execution of release forms.
(A) Licensees, associations, and societies shall report to the board a belief that a licensee suffers from impairment according to rule 4731-15-01 of the Administrative Code. Where the duty to report is relieved pursuant to paragraph (B) of that rule, the following requirements apply: (1) In order to ascertain the status of the practitioner's progress, the licensee, member, representative, or agent shall contact the approved treatment provider to ascertain the licensee's progress at least once weekly during the first four weeks following referral, and at least once monthly thereafter, and (2) If at any time the approved treatment provider indicates that the licensee has not continued to participate in accordance with section 4731.25 of the Revised Code, or if the approved treatment provider refuses to release information, the member, representative, or agent shall report to the board all information that led to the belief that the licensee suffers from impairment. (B) A licensee who has been referred to an approved treatment provider shall execute, and shall not revoke, appropriate release forms to allow the referring party to monitor his progress in treatment.
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Rule 4731-16-14 | Caffeine, nicotine, and over-the-counter drugs.
Effective:
September 1, 1999
Promulgated Under:
Ch 119.
The provisions of this chapter of the Administrative Code that prohibit use of drugs or substances do not apply to use of caffeinated foods or beverages, to tobacco products containing nicotine, or to the occasional therapeutic use of drugs available over the counter which lack the ability to alter mood or level of consciousness.
Last updated August 31, 2023 at 2:09 PM
Supplemental Information
Authorized By:
–
Amplifies:
–
Five Year Review Date:
Prior Effective Dates:
12/1/1991
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Rule 4731-16-15 | Patient rights.
(A) An approved treatment provider shall deal honestly with its patients and afford them the dignity and respect to which they are entitled as human beings. (B) While it is recognized that the high levels of denial and other defenses often displayed by patients in early recovery may necessitate the use of practices which might otherwise be viewed as coercive or heavy handed, an approved treatment provider shall employ such practices solely in the best interest of the patient. Under no circumstances shall such practices be employed to influence a patient to obtain aftercare or other forms of extended care from any particular treatment provider. Such practice may be employed in appropriate cases to influence a patient to obtain needed extended care from any approved treatment provider which has the capability to provide the care indicated. (C) An approved treatment provider shall maintain complete and accurate records for the benefit of the patient and the provider of any necessary extended residential treatment, aftercare, or counseling. (D) An approved treatment provider shall disclose to the patient in writing all known or reasonably anticipated costs of extended care which it proposes to render, and afford the patient the opportunity to obtain cost comparisons from other approved treatment providers. (E) Each patient who falls under the regulatory authority of the state medical board shall be given a written explanation, approved by the board, of the mandatory reporting requirements contained in Chapter 4730., 4731., 4760., or 4762. of the Revised Code.
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Rule 4731-16-17 | Requirements for one-bite program.
Effective:
January 31, 2019
(A) "One-bite program" is a
confidential program for treatment of impaired practitioners of the medical
board established pursuant to section 4731.251 of the Revised
Code. (B) "Monitoring organization"
is an entity which conducts the one-bite program and performs monitoring
services for impaired practitioners under a contract with the medical
board. (C) "One-bite treatment
provider" is an entity approved by the board to provide evaluation and
treatment to impaired practitioners participating in the one-bite
program. (D) "Continuing care
provider" is an entity approved by the board to provide continuing care
to impaired practitioners participating in the one-bite program pursuant to
rule 4731-16-21 of the Administrative Code. (E) Licensees of the board who may be impaired in the
ability to practice in accordance with acceptable and prevailing standards of
care and who want to participate in the one-bite program shall complete the
following requirements: (1) The licensee shall
register with the monitoring organization under contract with the board and
obtain a list of the one-bite program treatment providers approved by the
board. (2) If the licensee
reports directly to an approved treatment provider, the licensee shall register
with the monitoring organization upon referral from the approved treatment
provider. (3) The treatment
provider shall conduct an evaluation in accordance with rule 4731-16-05 of the
Administrative Code. (4) The treatment
provider shall provide the information regarding the diagnosis and eligibility
determination to the monitoring organization for confirmation of
eligibility. (5) If the licensee is
determined to be impaired and not to be eligible for the one-bite program, the
licensee, the monitoring organization and the treatment provider shall report
this information to the board. (F) Once a licensee is determined to be impaired and
eligible for the one-bite program, the licensee shall, within three days,
report to an approved treatment provider for treatment. The treatment provider
shall develop an individualized treatment plan that may include a combination
of inpatient, residential, partial hospitalization and/or intensive outpatient
treatment. (1) The licensee shall be
required to immediately suspend practice for a minimum of thirty days. The
licensee shall suspend practice until the licensee is determined to be able to
practice according to acceptable and prevailing standards by the treatment
provider and the medical director of the monitoring organization. (2) The treatment
provider shall notify the board and monitoring organization of any licensee who
returns to work prior to obtaining the release from the treatment provider and
the monitoring organization medical director. (3) The treatment
provider shall notify the board and monitoring organization of any licensee who
does not successfully complete the prescribed treatment. (G) Within one week after successful completion of
treatment, the monitoring organization shall ensure that the licensee has
entered into an agreement with a board approved continuing care
provider. (1) The monitoring
organization shall confirm that the licensee completes continuing care sessions
at least one time per week for at least six months following the release from
treatment. (2) The licensee must
continue the weekly continuing care meetings until released by the continuing
care provider and the medical director of the monitoring
organization. (H) In order to continue participation in the one-bite
program, after successful completion of treatment, the licensee shall enter
into an agreement with the monitoring organization for monitoring for at least
five years. An individual who chooses not to continue in the one-bite program
will be subject to the procedures in rule 4731-16-02 of the Administrative
Code. (1) The licensee shall be
required to provide random, observed toxicology screenings of biological
materials, including but not limited to, blood, urine, hair, saliva, breath, or
fingernail samples for drugs and alcohol as directed by the monitoring
organization with a minimum of two random, observed toxicology screenings per
month. (2) The licensee shall
attend drug and alcohol support group meetings (e.g. alcoholics anonymous or
narcotics anonymous) as directed by the monitoring organization with a minimum
of attendance at ten meetings per month. (3) The licensee shall be
released from monitoring by the medical director of the monitoring organization
upon successful completion of monitoring. (I) Any relapse as defined in paragraph (B) of rule
4731-16-01 of the Administrative Code /shall be reported to the board by the
medical director of the monitoring organization and the licensee. (J) The board shall develop guidelines in collaboration
with the monitoring organization for the reporting of non-compliance with
conditions of the one-bite program. Non-compliance shall be reported to the
board by the licensee and the medical director of the monitoring
organization.
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Rule 4731-16-18 | Eligibility for one-bite program.
Effective:
January 31, 2019
(A) An individual who holds a license
issued by the board to practice as a physician, massage therapist, cosmetic
therapist, physician assistant, anesthesiologist assistant, radiology
assistant, acupuncturist, oriental medicine practitioner, genetic counselor,
dietitian, or respiratory care therapist shall be eligible for the one-bite
program if all the following requirements are met: (1) The licensee has been
diagnosed with substance use disorder and is impaired in ability to practice in
accordance with acceptable and prevailing standards of care. (2) The licensee has not
previously participated in the one-bite program or the reporting exemption
under Chapter 4731-15 of the Administrative Code; (3) The licensee has not
had any prior disciplinary action for substance use disorder or impairment by a
licensing board in Ohio. (B) A licensee who fails to complete the
program requirements of the one-bite program shall not be eligible for
continued participation. (C) A licensee who relapses, as that term
is defined in rule 4731-16-01 of the Administrative Code, shall not be eligible
for continued participation in the one-bite program. (D) Participation in the one-bite program
does not exempt a licensee from being reported for or subject to discipline
under any other violation of the boards statutes and rules.
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Rule 4731-16-19 | Monitoring organization for one-bite program.
Effective:
January 31, 2019
(A) The board shall enter into a contract
with a monitoring organization to monitor licensees participating in the
one-bite program. The monitoring organization shall meet the following
criteria: (1) The monitoring
organization shall meet the requirements of section 4731.251 of the Revised
Code. (2) The monitoring
organization shall provide licensees with a list of treatment providers
approved for the one-bite program for the evaluation pursuant to rule
4731-16-05 of the Administrative Code. (3) The medical director
of the monitoring organization shall, along with the medical director of the
treatment provider, review and determine whether a licensee is able to practice
according to acceptable and prevailing standards of care. (4) The medical director
of the monitoring organization shall, along with the continuing care provider,
review and determine whether a licensee is eligible for release from continuing
care. (5) The monitoring
organization shall enter into monitoring agreements with licensees
participating in the one-bite program. (6) At the request of the
board, the medical director of the monitoring organization, or his or her
designee, shall provide testimony in any disciplinary proceeding involving a
licensee reported to the board by the monitoring organization (B) The agreements between the monitoring
organization and licensee shall establish the monitoring terms for at least
five years. (1) The agreement shall
provide that the licensee is required to participate in random observed
toxicology screenings of biological materials, including but not limited to
blood, urine, hair, saliva, breath, or fingernail samples for drugs or alcohol
no less than two times per month. (2) The agreement shall
provide that the licensee shall attend drug and alcohol support group meetings
(e.g. alcoholics anonymous or narcotics anonymous) as directed by the
monitoring organization with a minimum of ten meetings per month. (C) The medical director of the
monitoring organization shall review each licensee and make a determination as
to whether the licensee is released from monitoring. (D) The monitoring organization shall,
within seventy-two hours, report to the board any licensee who fails to comply
with the monitoring agreement in accordance with the non-compliance guidelines
established by the board and the monitoring organization. (E) The monitoring organization shall,
within seventy-two hours, report any relapse as defined in paragraph (B) of
rule 4731-16-01 of the Administrative Code to the board. (F) The monitoring organization shall
provide the following reports to the board on a quarterly basis: (1) The number and type
of licensees referred to the monitoring organization; (2) The number and type
of licensees under agreement with the monitoring organization; (3) The number and type
of licensees referred to the board; (4) The number and type
of licensees who successfully complete the monitoring agreement. (5) Information regarding
the treatment providers, the type of treatment and length of treatment for
licensees in the one-bite program; (6) Information regarding
source of referrals; (7) Other reports as
agreed between the board and the monitoring organization. (G) The monitoring organization, in
consultation with the board, shall provide education to the licensees,
treatment providers and continuing care providers regarding eligibility
criteria for the one-bite program and the boards statutes, rules and
policies regarding impairment. (H) The monitoring organization shall,
within seventy-two hours, report to the board any failure to complete treatment
or continuing care.
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Rule 4731-16-20 | Treatment providers in the one-bite program.
Effective:
January 31, 2019
(A) Criteria for approval of treatment
providers for individuals qualifying for the one-bite program shall include all
of the following: (1) Meet all requirements
for treatment providers in rule 4731-16-08 of the Administrative
Code. (2) Medical director is a
board-certified addictionologist or board-certified addiction psychiatrist and
is experienced in diagnosing and treating physicians and other health care
practitioners with substance use disorders; (a) The medical director shall oversee the initial
assessment and diagnosis, ongoing treatment processes, including medications,
treatment planning and discharge planning. (b) The medical director shall have knowledge and
experience with prescribing medications specifically indicated for use in
patients with substance use disorders and with medications to be avoided for
patients with substance use disorders. (c) The medical director shall have specific training and
knowledge regarding the interpretation of the results of toxicology screening
for drugs and alcohol. (3) A board-certified
psychiatrist is available to evaluate and provide treatment for co-occurring
mental health conditions. (4) Group therapy is
supervised by one of the following masters-level or higher qualifed
behavioral healthcare providers: (a) Board certified addictionologist, board certified
addiction psychiatrist, or psychiatrist licensed under Chapter 4731. of the
Revised Code; (b) Licensed independent chemical dependency
counselor-clinical supervisor, licensed independent chemical dependency
counselor, licensed chemical dependency counselor III, or licensed chemical
dependency counselor II licensed under Chapter 4758. of the Revised
Code; (c) Professional clinical counselor, licensed professional
counselor, licensed independent social worker, licensed social worker, or
marriage and family therapist licensed under Chapter 4757. of the Revised
Code; (d) Advanced practice registered nurse, licensed as a
clinical nurse specialist under Chapter 4723. of the Revised Code, who holds
certification as a psychiatric mental health clinical nurse specialist issued
by the American nurses credentialing center; (e) Advanced practice registered nurse, licensed as a nurse
practitioner under Chapter 4723. of the Revised Code, who holds certification
as a psychiatric mental health nurse practitioner issued by the American nurses
credentialing center; (f) Psychologist, as defined in division (A) of section
4732.01 of the Revised Code, licensed under Chapter 4732. of the Revised Code;
or (g) Advanced practice registered nurse licensed under
Chapter 4723. of the Revised Code, who holds subspecialty certification as a
certified addiction registered nurse-advanced practice issued by the addictions
nursing certification board. (5) Training regarding
the eligibility for the one-bite program shall be provided to all staff on a
quarterly basis. (6) Training regarding
the boards statutes, rules and policies regarding impairment and
reporting violations shall be provided to all staff on a quarterly
basis. (7) The treatment
provider shall be capable of completing evaluations pursuant to rule 4731-16-05
of the Administrative Code. (8) The treatment
provider provides abstinence-based education and treatment for all types of
substance use disorders. (9) The treatment
provider provides one or more of the following levels of patient care: medical
detoxification; inpatient or residential treatment; extended residential
treatment; partial hospitalization, intensive outpatient treatment, continuing
care or others as necessary. (10) The treatment
provider has the ability to provide extended residential care for patients who
require continued treatment of substance use disorders. (B) The medical director of the treatment
provider shall perform an evaluation pursuant to rule 4731-16-05 of the
Administrative Code to determine the degree of impairment of the licensee and
shall develop an individualized treatment plan. The individualized treatment
plan may include a combination of in-patient, residential, partial
hospitalization and intensive outpatient treatment. (1) The treatment
provider shall require the licensee to immediately suspend practice upon
entering into treatment (upon determination of impairment) and not return to
practice for at least thirty days. Clearance from the treatment provider
medical director and monitoring organization medical director are required for
return to practice. (2) The treatment
provider shall notify the monitoring organization of the determination of
impairment and the treatment plan. (3) The treatment plan
shall include, at least once per week, group therapy with other patients who
work in similar disciplines as the licensee or other
professionals. (4) The treatment plan
shall include education regarding the medical boards statutes, rules and
policies with respect to impairment. (5) The treatment plan
shall include education and group therapy to assist the patient to transition
back to work. (C) The treatment provider shall report
instances of violations of this chapter to the monitoring organization and the
board. (D) The treatment provider shall complete
and maintain records for each licensee seen for evaluation or treatment under
the one-bite program in accordance with paragraph (C) of rule 4731-16-07 of the
Administrative Code. (E) Each quarter, the treatment provider
shall provide to the monitoring organization and the board the following
records regarding licensees seen for evaluation or treatment under the one-bite
program: (1) Number of licensees
referred for evaluation (including self-referrals); (2) Number of licensees
evaluated; (3) Number of licensees
determined to be eligible for one-bite program; (4) Number of referral
sources by category (e.g., self-referrals, board referrals, medical society
referrals, referrals by colleagues); (5) Number of licensee
evaluations which resulted in treatment recommendations for substance use
disorder; (6) Number of licensees
treated based on the treatment providers own recommendations; (7) Number of licensees
treated based on transfer or referral from other treatment
providers; (8) Number of licensees
who entered each phase of treatment; (9) Number of licensees
engaged in each phase of treatment; (10) Number of licensees
who successfully completed each phase of treatment; (11) Number of licensees
discharged from each phase of treatment other than upon successful completion,
and the rationale for each such discharge; (12) Number of licensee
relapses identified during continuing care and following continuing
care; (13) Number and names of
licensees reported to the board under this chapter of the Administrative
Code. (14) Number and
identities of referral sources notified of the treatment providers
inability to release information under federal law. (F) The reports provided to the board
shall not contain identifying information for the licensee participating in the
one-bite program.
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Rule 4731-16-21 | Continuing care for one-bite program.
Effective:
January 31, 2019
(A) In order to provide continuing care
to a licensee in the one-bite program, a continuing care provider shall enter
into a continuing care agreement with the licensee. The agreement term shall be
established by the continuing care provider but may not be for less than six
months. (B) The continuing care provider shall be
approved by the board. (C) A continuing care provider shall
provide therapy led by one of the following master's-level or higher
qualified behavioral healthcare providers: (1) Board certified
addictionologist, board certified addiction psychiatrist, or psychiatrist
licensed under Chapter 4731. of the Revised Code; (2) Licensed independent chemical
dependency counselor-clinical supervisor, licensed independent chemical
dependency counselor, licensed chemical dependency counselor III, or licensed
chemical dependency counselor II licensed under Chapter 4758. of the Revised
Code; (3) Professional clincal counselor,
licensed professional counselor, licensed independent social worker, licensed
social worker, or marriage and family therapist licensed under Chapter 4757. of
the Revised Code; (4) Advanced practice registered nurse,
licensed as a clinical nurse specialist under Chapter 4723. of the Revised
Code, who holds certification as a psychiatric mental health clinical nurse
specialist issued by the American nurses credentialing center; (5) Advanced practice
registered nurse, licensed as a nurse practitioner under Chapter 4723. of the
Revised Code, who holds certification as a pyschiatric mental health nurse
practitioner issued by the American nurses credentialing center; (6) Psychologist, as
defined in division (A) of section 4732.01 of the Revised Code, licensed under
Chapter 4732. of the Revised Code; or (7) Advanced practice
registered nurse licensed under Chapter 4723. of the Revised Code, who holds
subspecialty certification as a certified addiction registered nurse-advanced
practice issued by the addictions nursing certification board. (D) Continuing care meetings shall be
held at least one time per week, with missed meetings made up. (1) Continuing care
meetings shall be at least one hour in duration. (2) The continuing care
provider shall provide status reports for each participating licensee to the
monitoring organization no less than quarterly. (E) The continuing care provider shall report to the
monitoring organization no less than quarterly and shall provide the following
documentation to the monitoring organization on a quarterly basis: (1) The number and type
of licensees entering into continuing care agreements; (2) The number and type
of licensees released by the continuing care program; (3) The average length of
the continuing care agreements; and (4) The number and type
of licensees who relapse. (F) The continuing care provider shall report a licensee
who relapsed to the board and the monitoring organization. The continuing care
provider shall report to the board and the monitoring organization if the
licensee fails to comply with the terms of the continuing care
agreement. (G) Release from continuing care must be reviewed and
agreed upon by the medical director of the monitoring
organization.
Last updated August 31, 2023 at 2:09 PM
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