Tag: drugs

Medical Board, Medical practice in Ohio, State Medical Board of Ohio, Uncategorized

Ohio Counselor, Social Worker, and Marriage and Family Therapist Board Responds to Corona Virus

In connection with the Corona Virus, we have received numerous inquiries from our Ohio counselor and social worker clients concerning teletherapy services.

The Ohio Counselor, Social Worker, and Marriage and Family Therapist Board (“CSWMFT Board”) recently posted the following information on its website:

The Board’s rules regarding providing teletherapy are established in Ohio Administrative Code Chapter 4757-5-13. Licensees who are considering offering services via teletherapy should be mindful of the following:

  • Independent licensees (LISW, LPCC, IMFT), dependent licenses (LSW, LPC, MFT) working under supervision, and trainees (SWT, CT, MFTT) working under supervision, can all provide teletherapy provided they have training and experience in teletherapy. Examples of training include the completion of continuing education, supervised experience, and peer consultation.
  • Services must be provided to ensure the highest level of confidentiality. Video-conferencing software should be HIPAA compliant.
  • Licensees should carefully consider whether teletherapy is an appropriate means of providing services to individual clients.
  • Licensees must be mindful that ORC 4757 and OAC 4757 apply regardless of how services are provided.
  • Licensees who voluntarily choose to suspend providing services must properly terminate with clients and provide referrals as required in the rules. If a licensee is suspending services in response to a public order to do so, the licensee or their employer is advised to provide information, for example on outgoing voicemail messages or websites, regarding resources in the event a client is in crisis.
  • Insurers establish which services are eligible for reimbursement. Be sure to verify whether you can bill for teletherapy before providing services to a client. The Board has no authority to direct insurers to pay for teletherapy services.
  • Agencies and practices may set their own rules regarding teletherapy. The Board can exercise no authority over these employment/business related decisions.

While the Board staff want to be as helpful as possible, we are not able to provide specific guidance regarding implementing teletherapy. Please consult with peers and supervisors. Additionally, Board staff cannot recommend specific software, nor can the Board recommend specific training programs.

  • As the State of Ohio’s response to COVID-19/Corona Virus evolves, the Board will share information with licenses.

PLEASE ALSO NOTE: The CSWMFT Board also recently posted the following update on its website:

Teletherapy Update – Emergency Rule in Progress

The CSWMFT Board is working with Governor Mike DeWine’s office as well as other State agencies on an emergency rule that will provide flexibility for licensees who are seeking to provide teletherapy. We anticipate the proposed rule will be issued soon and will align with the rules being proposed by the Ohio Department of Medicaid and Ohio Department of Mental Health and Addiction Services. Once the rule is issued, we will provide an update and additional guidance.

Below are some additional resources about teletherapy and COIVD-19:

State of Ohio

https://coronavirus.ohio.gov/wps/portal/gov/covid-19/

https://cswmft.ohio.gov/Home/COVID-19

 Counseling

AMHCA Code of Ethics
http://www.nymhca.org/AMHCACodeofEthics.pdf

NBCC
https://www.nbcc.org/Assets/Ethics/NBCCPolicyRegardingPracticeofDistanceCounselingBoard.pdf

ACA
https://www.counseling.org/knowledge-center/mental-health-resources/trauma-disaster/mental-health-professional-counseling-and-emergency-preparedness

ACA
https://www.counseling.org/knowledge-center/mental-health-resources/trauma-disaster/working-with-your-clients?utm_source=informz&utm_medium=email&utm_campaign=covidresources

CACREP
https://www.cacrep.org/for-programs/updates-on-covid-19/

 Social Work

NASW Ohio Chapter
https://www.naswoh.org/page/telehealth2020

NASW
https://www.socialworkers.org/Practice/Infectious-Diseases/Coronavirus

NASW
https://www.socialworkers.org/includes/newIncludes/homepage/PRA-BRO-33617.TechStandards_FINAL_POSTING.pdf

NASW
https://naswassurance.org/malpractice/malpractice-tips/treading-through-teletherapy-treatment-topics/

Marriage and Family Therapy

AAMFT
http://www.aamft.org/iMIS15/AAMFT/Content/Legal_Ethics/Code_of_Ethics.aspx

AAMFT
https://www.aamft.org/Events/Coronavirus-Event-Status-Updates.aspx?WebsiteKey=8e8c9bd6-0b71-4cd1-a5ab-013b5f855b01

NIMH
https://www.nih.gov/health-information/coronavirus

APA
https://www.apa.org/practice/programs/dmhi/research-information/social-distancing

American Telemedicine Association
http://www.americantelemed.org/resources/telemedicine-practice-guidelines/telemedicine-practice-guidelines#.VS_Go40tGUk

http://www.gpo.gov/fdsys/pkg/FR-2011-05-05/pdf/2011-10875.pdf

Medicaid
https://www.medicaid.gov/medicaid/benefits/downloads/medicaid-telehealth-services.pdf

HHS
https://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/notification-enforcement-discretion-telehealth/index.html

Medicare
https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet

In consideration of the rapidly-changing situation in which we find ourselves, we recommend and encourage Ohio counselors, social workers, and marriage and family therapist licensees to frequently visit the CSWMFT Board website. As always, if you have questions about this post or the CSWMFT Board, please contact Todd Collis or Beth Collis.

State Medical Board of Ohio

Ohio Medical Board has adopted New Rules Related to Office Based Opioid Treatment

The State Medical Board of Ohio has adopted new rules related to Office Based Opioid Treatment (“OBOT”).  The new news take effect January 31, 2015.  The new rules require specific protocols, pretreatment examinations, and ongoing physician face-to-face examinations, testing and individualized treatment plans.  A copy of the new rules can be found at: http://med.ohio.gov/pdf/rules/NewRules/4731-11-12-eff-1-31-15.pdf.

The new rules include but are not limited to:

  1. Prior to providing OBOT, the physician must conduct an assessment of the patient that meets the requirements of the rule.
  2. The physician must practice in accordance with one of the protocols listed in the rule, and the diagnosis of an opioid disorder must be made utilizing the criteria in the DSM, 4th or 5th edition.
  3. The physician must develop an individualized treatment plan for the patient, require the patient to actively participate in appropriate behavioral counseling or treatment for addiction, and provide ongoing toxicological testing.
  4. The physician’s prescribing of the medication must comply with requirements that include, but are not limited to, prescribing only drugs specifically approved by the FDA for use in maintenance and detoxification treatment, prescribing no more than 16 milligrams of medication daily for a patient unless specified requirements are met, and accessing OARRS for each patient no less frequently than every 90 days.
  5. The physician must complete Category I CME related to substance abuse and addiction every two years, which will be accepted as part of the CME requirement for license renewal.

The above summary highlights certain requirements of the new rules and is not a substitute for the new rules.  The new rules can be found at: http://med.ohio.gov/pdf/rules/NewRules/4731-11-12-eff-1-31-15.pdf.

As always, if you have any questions regarding this post or the State Medical Board of Ohio in general, please contact one of the attorneys at Collis, Smiles and Collis at 614-486-3909 or email Todd@collislaw.com.

State Medical Board of Ohio, Uncategorized

What the Medical Board really cares about – sex, drugs & lies

Today is the State Medical Board of Ohio’s monthly Board meeting. It is always scheduled for the second Wednesday of the month. Decisions on disciplinary actions are always scheduled on the 1pm docket. It is a  cattle call. All disciplinary actions are deliberated and final decisions are voted on in open session. Members of the public, including medical students, and the press are welcome to and do attend.

The first question I am always asked by physicians is “What will get me in trouble with the Medical Board”.  While the Medical Board can discipline a licensee for a wide range of things, there are three areas that seem to be of their highest concern: Sex, Drugs and Lies.

Sex. The Board typically takes disciplinary action against a licensee who has sex with a patient. However, the Board is also concerned with boundary violations with patients. Have you employed a patient in your office or loaned money to a patient or signed a car note or credit card application for a client? The line in the sand between a doctor and a patient should be clear. There should be no overlapping of a doctor/patient relationship and a personal relationship.

Drugs. Nearly half of all disciplinary actions handled by the Medical Board each year involve impaired physicians. Physicians who have been diagnosed with drug or alcohol problems. The Medical Board is also very concerned about the prescribing habits of physicians. Has the physician prescribed to the mother of a patient as opposed to the patient because only the mother has insurance? Has the physician prescribed a controlled substance to a family member?  Has the physician prescribed a drug to a patient for other than legitimate medical purposes?

Lies. The Medical Board does not like to be lied to. If you complete an application and fail to give clear, concise and accurate information to the Board, you will likely face a disciplinary action. Similarly, if you are the subject of discipline by another state and fail to tell the Ohio Board, you will likely be subject to discipline in Ohio not just for the “sister state discipline” but also for failing to disclose the action to the Ohio Board.

At the Board meeting today, the Board will consider final discipline in four cases. One involves practicing below the standard of care in the prescribing of medications to four patients that also resulted in felony and misdemeanor convictions; two cases relate to alcohol abuse or addiction and relapse and one involves an inappropriate sexual relationship with a patient. http://www.med.ohio.gov/pdf/Agenda/Agenda%20-2012/03-12agenda.pdf

Off to the meeting….

As always, if you have any questions about this post or about the State Medical Board of Ohio, feel free to email me at beth@collislaw.com or call me at 614-486-3909. I look forward to your questions.