In early 2018, the Ohio Academy of Family Physicians, in partnership with other physicians’ organizations and treatment providers, achieved a major legislative victory that at many times over the last four years seemed unlikely. Passage of House Bill (HB) 145 on January 24, 2018, marked a milestone on a long and arduous journey to ensure that physicians can seek confidential services to improve their health and well-being as a means to ensure patient care safety. A contentious stalemate with the State Medical Board of Ohio (SMBO) eventually gave way to collaboration that resulted in passage of legislation that maintains a physician’s ability to seek treatment for drug, alcohol, or other substance abuse if certain specified conditions are met.
- Examination at an approved treatment provider
- If diagnosed with impairment, the individual completes treatment in accordance with SMBO requirements; and
- The individual has not violated SMBO statutes or rules, other than those relating to impairment.
HB 145 clears up uncertainty about eligibility criteria for one-bite participation, without jeopardizing the confidentiality assured under the existing program. The legislation also specifies the criteria for operation of treatment facilities and for the organization assigned to monitor one-bite participants. In addition, the legislation requires the SMBO to contract with one organization to conduct the one-bite program and to perform the monitoring services related to the program. It is expected that the organization selected will be the Ohio Physicians Health Program (OPHP).
The OPHP is a nonprofit organization that offers confidential assistance to physicians and other health care professionals who may be affected by mental, emotional, and behavioral illness, substance-related, and addictive disorders. Their mission is to facilitate the health and wellness of health care professionals in order to enhance patient care and safety. For more than four decades, the OPHP has been confidentially helping impaired physicians regain the health and well-being needed to serve their patients.
HB 145 pertains only to substance abuse and addiction, and continues to leave open impairment because of mental or physical illness question. Nevertheless, due to the persistence of the OAFP and other physician organizations, the SMBO is now drafting proposed rules that, if adopted, would establish a confidential monitoring program that allows licensees with mental or physical illnesses, other than substance use disorders, to be monitored by the SMBO without being subjected to formal public disciplinary action. For those eligible physicians, non-disciplinary SMBO actions would not be reported to the National Practitioners Data Bank. The rule language does not go as far as the one-bite legislation in permitting the licensee to seek treatment confidentially (without involvement from the SMBO), but it is definitely another step in the right direction.
De-identified data from the non-disciplinary program will be evaluated once it is implemented. In addition, future decisions on disability discrimination rendered by the U.S. Department of Justice will be reviewed prior to deciding if additional legislative action is needed.
Although the OAFP has actively involved in writing these rules as well as the draft rules to implement HB 145, we were surprised to that significant changes were made to the most recent draft rules the SMBO circulated for comment. Comments have been submitted on the proposed changes and a meeting has been requested for the draft rules to be amended to honor the previously agreed on principles .
Additional Information and Resources
- Medical Association Coalition Submits One-Bite Comments to Common Sense Initiative (Weekly Family Medicine Update, June 19, 2018)
- Ohio Medical Board Draft One-Bite Rules Violate the Spirit of HB 145 (Weekly Family Medicine Update, April 10, 2018)
- Medical Board Draft One-Bite Rules Violate the Spirit of HB 145 (Weekly Family Medicine Update, April 10, 2018)
- Rules for Confidential Monitoring Program for Licensees with Mental or Physical Illnesses Proposed (Weekly Family Medicine Update, February 13, 2018)
- Rules Writing Process for One-Bite to Begin (Weekly Family Medicine Update, February 6, 2018)
- One-Bite Legislation Passes Senate (Weekly Family Medicine Update, January 30, 2018)
- Letter to State Medical Board Reaffirms Concerns with Program Rules (Weekly Family Medicine Update, December 12, 2017)
- Medical Board Meets with Physician Organizations on Creation of Non-disciplinary, Confidential Monitoring Program for Licensees with Physical or Mental Illness (Weekly Family Medicine Update, November 21, 2017)
- One-Bite Legislation Likely to Pass This Fall (Weekly Family Medicine Update, October 10, 2017)
- OAFP Joins with Other Physician Organizations in Submitting Comments on Medical Board Confidential Monitoring Program Rules (Weekly Family Medicine Update, May 2, 2017)
- Bill to Improve One-Bite is Ready for Introduction (Weekly Family Medicine Update, February 14, 2017)
- One-Bite Negotiations Continue (Weekly Family Medicine Update, November 29, 2016)
- One-Bite Workgroup Ground Rules Set (Weekly Family Medicine Update, May 31, 2016)
- One-Bite Meeting Held (Weekly Family Medicine Update, May 24, 2016)
- The Columbus Dispatch Editorial Praises Tough Medical Board (Weekly Family Medicine Update, May 10, 2016)
- State Medical Board Story about Disciplinary Actions in The Columbus Dispatch (Weekly Family Medicine Update, May 3, 2016)
Medical Associations Coalition Responds to State Medical Board’s Withdrawal of One-Bite Legislation (Weekly Family Medicine Update, February 23, 2016)
Medical Associations Coalition Meets Relative to One-Bite Working Group (Weekly Family Medicine Update, February 16, 2016)
State Medical Board Drops One-Bite Legislation Push for Now (Weekly Family Medicine Update, February 9, 2016)