State Medical Board Handling of Mental & Physical IllnessMichael Schot

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Document on Subject : "State Medical Board Handling of Mental & Physical IllnessMichael Schot"— Transcript:

1 State Medical Board Handling of Mental &
State Medical Board Handling of Mental & Physical IllnessMichael Schottenstein, M.D. Board PresidentAugust 19, 2020 StatutesLaws enacted by Ohio legislatureOhio Revised Code (ORC)RulesRegulations developed and enacted by Medical BoardOhio Administrative Code (OAC)Rules clarify & amplify provisions

2 in the Ohio Revised Code Medical Board M
in the Ohio Revised Code Medical Board Members Michael Schottenstein, MDPresidentMark Bechtel, MDVice PresidentBruce Saferin, DPMSupervising MemberKim Rothermel, MDSecretaryAmol Soin, MD, MBARobert Giacalone, RPh, JDMichael Gonidakis, JDBetty Montgomery, JDSherry Johnson, MDJonathan Feibel, MDHaris

3 h Kakarala, MD The Board The Medical Bo
h Kakarala, MD The Board The Medical Board is the state agency charged with regulating the practice of medicine and selected other health professions. 12 members appointed by the governor to 5year terms:9 doctors: 7 MDs, 1 DO, and 1 DPM3 consumer members The board meets the second Wednesday of ea

4 ch month and is temporarily License Typ
ch month and is temporarily License TypesThe Medical Board regulates more than 93,000 licensees. Data from FY20 annual report Allopathic Physicians44,130AnesthesiologistAssistantsMassage Therapists 11,949OsteopathicPhysicians7,326Physician Assistants4,340Cosmetic Therapists PodiatricPhysicians

5 1,003RadiologistAssistants Acupuncturis
1,003RadiologistAssistants Acupuncturists Training CertificatesDPM9,263Genetic Counselors OrientalMedicine PractitionersDietitians4,701Respiratory Care8,884 Medical Board Core Services Licensure Confidential investigations Disciplinary actions Probationary monitoring Education & Outreach Licen

6 sure All professionals regulated by the
sure All professionals regulated by the Medical Board must have a license issued by the Board before they can practice in Ohio. Licensure staff reviews the applications to be sure that the applicant qualifies for a license. The Deputy Director of Licensure has authority to approve applications. Wh

7 at is a complaint? Anyallegation of lice
at is a complaint? Anyallegation of licensee misconduct received by the Medical Board Complaints are confidential Medical Board InvestigationsOhio law makes complaints received by the Medical Board and board investigations confidentialThe board may only share investigative information with law enf

8 orcement agencies, other licensing board
orcement agencies, other licensing boards, or other governmental agencies that are prosecuting, adjudicating or investigating alleged violations of statutes or rulesBoard disciplinary actions are public recordposted on med.ohio.gov and licensee profile on elicense.ohio.gov Complaint Received Not w

9 ithin board’s jurisdiction Complain
ithin board’s jurisdiction Complaint closed Complaint does not support disciplinary action Complaint closed Investigation supports disciplinary action by board; enforcement staff develops case for disciplinary action Consent agreement ratified by board Board approves issuance of a citation No

10 hearing requested by licensee Hearing E
hearing requested by licensee Hearing Examiner prepares proposed findings and order (PFPO) for board review Board votes to accept or amend PFPO Legal department prepares findings, order, journal entry (FOJE) for board review Board votes to accept or amend FOJE Hearing requested by licensee; hear

11 ing held Hearing Examiner prepares repor
ing held Hearing Examiner prepares report & recommendation (R&R) for boardreview Board votes to accept or amend R&RDisciplinary Action PublicInformation Information ConfidentialComplaint, Investigation, Enforcement and Disciplinary Process Types of Consent Agreements Probationary Temporary Limitat

12 ion Reprimand Permanent Limitation Defin
ion Reprimand Permanent Limitation Definite Suspension Permanent Withdrawal Indefinite Suspension Permanent Surrender Other Types of Formal Disciplinary Action Notice of opportunity for hearing Summary suspension Automatic suspension Confidential Monitoring Program These slides pertain to the M

13 edical Board’s enforcement of Secti
edical Board’s enforcement of Section 4731.22(B)(19), Ohio Revised Code, related to mental or physical illnesses excluding chemical abuse or dependency *Substance use disorder has a different set of statutes/rules Diagnosis ≠ Disciplinary Action your ability to practice according to prevaili

14 ng and acceptable standards of care:No l
ng and acceptable standards of care:No legal basis for the Board to take any disciplinary actionAll investigations are confidentialyour ability to practice according to standards without tx/monitoring/supervision:New confidential monitoring program became effective August 31, 2018Formal action w

15 here warranted Current Application Quest
here warranted Current Application Question diagnosed as having, or been hospitalized for a medical condition which in any way impairs or limits your ability to practice with reasonable skill and safety? Board Authority is Limited Diagnosis AloneA diagnosis alone is not a basis for any board disci

16 plinary action Other ViolationsYesCrimin
plinary action Other ViolationsYesCriminal acts or convictions associated with a mental illness can trigger an independent basis for disciplinary action Mental/PhysicalMaybeAuthority limited to situations impacting ability to practice according to acceptable and prevailing standards of care What t

17 o Expect All investigations confidential
o Expect All investigations confidential under 4731.22(F)(5), ORC State Medical Board of Ohio v. Miller , Supreme Court of Ohio (July 26, 1989) allows Board to subpoena medical records Some information necessarily disclosed if subsequent formal disciplinary action results Boardordered evaluation Cl

18 inical diagnosis Does the diagnosis pote
inical diagnosis Does the diagnosis potentially impact ability to practice? Is treatment, monitoring, or supervision required to practice safely? Qualifications for Confidential Monitoring ProgramCooperation/releasesUndertake treatmentAdhere to treatment planAny prior discipline in Ohio or elsewher

19 e was limited to (B)(19) onlyNot on prob
e was limited to (B)(19) onlyNot on probation nowNo sexual boundary issuesNo criminal conduct or convictionsNo other actionable violationsNo past or current threats of violence or acts of violence against property or individualsNo information indicating that allowing nonpublic monitoring creates ri

20 sk of potential patient Ohio Administrat
sk of potential patient Ohio Administrative Code 4731 Diagnosis alone does not mandate disciplinary actionHowever, you must answer truthfully. Failing to answer the application questions truthfully = licensure fraud Most (B)(19) issues are reviewed and determined not to be actionableMany individual

21 s will qualify for the new confidential
s will qualify for the new confidential monitoring programWhen formal public action is unavoidable, the board will work with you to reach a settlement where possible. Don’t Create Problem Don’t Be AfraidDiagnosis ≠ Diagnosis Program Statistics Because the program is confidential, the

22 identities of the participants are prote
identities of the participants are protected:There are seven current participantsIt is possible for two of the participants to be released by the end of the year the board Secretary and Supervising Member must give approval Program Statistics 100% of participants in compliance(Regular reports relat

23 ed to their requirements (typically psyc
ed to their requirements (typically psychiatric treatment and/or psychotherapy) Most participants have multiple mental health diagnoses (e.g., anxiety and depression) All participants have remained stable during the monitoring period Licensees have a personal duty to report to the State Medical Boa

24 rd of Ohio when they believe an individu
rd of Ohio when they believe an individual licensed by the Board has violated the Board’s laws or rules including exual misconduct, impairment, practice below the minimal standards of care, and improper prescribing of controlled substancesReports of misconduct to supervisors, law enforcement o

25 r health care system management do NOTfu
r health care system management do NOTfulfill the duty to report to the Board; failure to report could result in formal disciplinary action.Duty to Report Case: Duty to Reportpartner and coowner of their pain management practice was accused of engaging in sexual misconduct with female patients dur

26 ing medical exams.He failed to report hi
ing medical exams.He failed to report his partner’s inappropriate sexual conduct to the Medical Board. Board action: Permanent revocation State Medical Board of Ohio's Confidential Complaint Hotline SMBO (7626) Ohio Physicians Health Program (OPHP) OPHP offers confidential resources for ment

27 al health, emotional and behavioral illn
al health, emotional and behavioral illness, wellness coaching services and more.To view available provider wellness resources, visit Additional Resource Crisis Text Line: Text 4HOPE to 741 741 Michael Schottenstein, M.D.Board PresidentState Medical Board of Ohio30 E. Broad Street Columbus, OH 432