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	<title>Health License Defense &#187; Impairment</title>
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	<description>The blogs of our partners.</description>
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		<title>New Standard of Care Rules for Texas Dentists</title>
		<link>http://www.healthlicensedefense.com/b/2010/06/new-standard-of-care-rules-for-texas-dentists/</link>
		<comments>http://www.healthlicensedefense.com/b/2010/06/new-standard-of-care-rules-for-texas-dentists/#comments</comments>
		<pubDate>Wed, 09 Jun 2010 22:02:26 +0000</pubDate>
		<dc:creator>Taralynn Mackay</dc:creator>
				<category><![CDATA[Other Professionals]]></category>
		<category><![CDATA[Agreed Order]]></category>
		<category><![CDATA[complaint]]></category>
		<category><![CDATA[criminal history]]></category>
		<category><![CDATA[Dental]]></category>
		<category><![CDATA[Dentist]]></category>
		<category><![CDATA[dentist complaint]]></category>
		<category><![CDATA[Impairment]]></category>
		<category><![CDATA[mental]]></category>
		<category><![CDATA[mental illness]]></category>
		<category><![CDATA[physical impairment]]></category>
		<category><![CDATA[Texas Board of Dental Examiners]]></category>
		<category><![CDATA[texas dental board]]></category>

		<guid isPermaLink="false">http://www.healthlicensedefense.com/b/?p=114</guid>
		<description><![CDATA[The following rules were posted for adoption in the Texas Register  (earliest possible date is June 20, 2010) and they expand the regulatory reach of the Texas Dental Board (the underline is the new language and the strikeout is the old language of the rules):
§108.9.Dishonorable Conduct. 
The dishonorable conduct section is intended to protect the [...]]]></description>
			<content:encoded><![CDATA[<p>The following rules were posted for adoption in the <a href="http://www.sos.state.tx.us/texreg/archive/May212010/PROPOSED/22.EXAMINING%20BOARDS.html#60" target="_blank">Texas Register  (</a>earliest possible date is June 20, 2010) and they expand the regulatory reach of the Texas Dental Board (the <span style="text-decoration: underline">underline</span> is the new language and the <span style="text-decoration: line-through">strikeout</span> is the old language of the rules):</p>
<p><em>§108.9.Dishonorable Conduct. </em></p>
<p><span style="text-decoration: underline">The dishonorable conduct section is intended to protect the public from dangerous, unethical, and illegal conduct of licensees. The purpose of this section is to identify unprofessional or  dishonorable behaviors of a licensee which the Board believes are likely to pose a threat to the public. Actual injury to a patient need not be  established for a licensee to be in violation of this section. Behavior constituting dishonorable conduct includes, but is not limited to</span> [<span style="text-decoration: line-through">A licensee is in violation of this rule if he or she</span>]:</p>
<p><span style="text-decoration: underline">(1) Criminal conduct&#8211;including but not limited to conviction of a misdemeanor involving fraud or a felony under federal law or the law of any state as outlined in Chapter 101 of this title.</span></p>
<p><span style="text-decoration: line-through">[(1) Aids or abets in the violation of a criminal statute or participates in a conspiracy to procure (by corruption, fraud, misrepresentation, or bribery, or both) a dental license for an unqualified person.]</span></p>
<p><span style="text-decoration: underline">(2) Deception or misrepresentation&#8211;engages in deception or misrepresentation: </span></p>
<p><span style="text-decoration: underline">(A) in soliciting or obtaining patronage; or </span></p>
<p><span style="text-decoration: underline">(B) in obtaining a fee. </span></p>
<p><span style="text-decoration: underline">(3) Fraud in obtaining a license&#8211;obtains a license by fraud or misrepresentation or participates in a conspiracy to procure a license, registration, or certification for an unqualified person. </span></p>
<p><span style="text-decoration: underline">(4) Misconduct involving drugs or alcohol&#8211;actions or conduct that include, but are not limited to:</span></p>
<p><span style="text-decoration: underline">(A)</span> [<span style="text-decoration: line-through">(2)</span>] <span style="text-decoration: underline">providing</span> [<span style="text-decoration: line-through">Provides </span> ] dental services to a patient while the licensee is impaired through the use of drugs, narcotics, or alcohol <span style="text-decoration: underline">;</span>[<span style="text-decoration: line-through">.</span>]</p>
<p><span style="text-decoration: underline">(B) addicted to or habitually intemperate in the use of alcoholic beverages or drugs; </span></p>
<p><span style="text-decoration: underline">(C) improperly obtained, possessed, or used habit-forming drugs or narcotics including self-prescription of drugs;</span></p>
<p><span style="text-decoration: underline">(D)</span> [<span style="text-decoration: line-through">(3)</span>] <span style="text-decoration: underline">grossly</span> [<span style="text-decoration: line-through">Grossly</span> ] over prescribes, dispenses, or administers narcotic drugs, dangerous drugs, or controlled substances<span style="text-decoration: underline">;</span>[<span style="text-decoration: line-through">.</span>]</p>
<p><span style="text-decoration: underline">(E)</span> [<span style="text-decoration: line-through">(4)</span>] <span style="text-decoration: underline">prescribes</span> [<span style="text-decoration: line-through">Prescribes</span> ], dispenses, or administers narcotic drugs, dangerous drugs, or controlled substances to or for a person who is not his or her dental patient<span style="text-decoration: underline">;</span>[<span style="text-decoration: line-through">,</span>] or [<span style="text-decoration: line-through">not for a dental purpose.</span>]</p>
<p><span style="text-decoration: underline">(F) prescribes, dispenses, or administers narcotic drugs, dangerous drugs, or controlled substances to a person for a non-dental purpose, whether or not the person is a dental patient. </span></p>
<p><span style="text-decoration: underline">(5) Assisting another in engaging in the unauthorized practice of dentistry or dental hygiene&#8211;holds a dental license and employs, permits, or has employed or permitted a person not licensed to practice dentistry to practice dentistry in an office of the dentist that is under the dentist&#8217;s control or management. </span></p>
<p><span style="text-decoration: underline">(6) Failure to comply with applicable laws, rules, regulations, and orders&#8211;violates or refuses to comply with a law relating to the regulation of dentists, dental hygienists, or dental assistants; fails to cooperate with a Board investigation; or fails to comply with the terms of a Board Order. </span></p>
<p><span style="text-decoration: underline">(7) Inability to practice safely&#8211;is physically or mentally incapable of practicing in a manner that is safe for the person&#8217;s dental patients. </span></p>
<p><span style="text-decoration: underline">(8) Discipline of a licensee by another state board&#8211;holds a license or certificate to practice dentistry or dental hygiene in another state and the examining board of that  state: </span></p>
<p><span style="text-decoration: underline">(A) reprimands the person; </span></p>
<p><span style="text-decoration: underline">(B) suspends or revokes the person&#8217;s license or certificate or places the person on probation; or </span></p>
<p><span style="text-decoration: underline">(C) imposes another restriction on the person&#8217;s practice. </span></p>
<p><span style="text-decoration: underline">(9) Failure to comply with Medicaid, insurance, or other regulatory laws&#8211;knowingly provides or agrees to provide dental care in a manner that violates a federal or state law that: </span></p>
<p><span style="text-decoration: underline">(A) regulates a plan to provide, arrange for, pay for, or reimburse any part of the cost of dental care services; or </span></p>
<p><span style="text-decoration: underline">(B) regulates the business of insurance. </span></p>
<p><span style="text-decoration: underline">(10) Improper delegation&#8211;improperly delegates any task to any individual who is not permitted to perform the task by law, this chapter, or practice restrictions imposed by Board Order.</span></p>
<p><span style="text-decoration: line-through">[(5) Indicates a fee for dental services on an insurance or other third party reimbursement claim form which is other than the fee which the dentist expects to collect for services rendered.]</span></p>
<p><span style="text-decoration: underline">(11)</span> [<span style="text-decoration: line-through">(6)</span>] <span style="text-decoration: underline">Unprofessional conduct engages&#8211;</span>[<span style="text-decoration: line-through">Engages</span>] in conduct that has  become established through professional experience as likely to disgrace, degrade, or bring discredit upon the licensee or the dental profession.</p>
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		</item>
		<item>
		<title>Trying to find a job while under a Board Order</title>
		<link>http://www.healthlicensedefense.com/b/2010/02/trying-to-find-a-job-while-under-a-board-order/</link>
		<comments>http://www.healthlicensedefense.com/b/2010/02/trying-to-find-a-job-while-under-a-board-order/#comments</comments>
		<pubDate>Wed, 03 Feb 2010 16:30:09 +0000</pubDate>
		<dc:creator>Taralynn Mackay</dc:creator>
				<category><![CDATA[Nurses]]></category>
		<category><![CDATA[Agreed Order]]></category>
		<category><![CDATA[Board Order]]></category>
		<category><![CDATA[BON]]></category>
		<category><![CDATA[Impairment]]></category>
		<category><![CDATA[Informa Settlement Conference]]></category>
		<category><![CDATA[ISC]]></category>
		<category><![CDATA[Malpractice Insurance]]></category>
		<category><![CDATA[mental illness]]></category>
		<category><![CDATA[mid-level providers]]></category>
		<category><![CDATA[monitoring order]]></category>
		<category><![CDATA[National Practitioner's Databank]]></category>
		<category><![CDATA[nursing jurisprudence]]></category>
		<category><![CDATA[substance abuse]]></category>
		<category><![CDATA[Texas Board of Nurses]]></category>
		<category><![CDATA[Texas Board of Nursing]]></category>

		<guid isPermaLink="false">http://www.healthlicensedefense.com/b/?p=72</guid>
		<description><![CDATA[I have heard from another nurse who is having a difficult time obtaining a job while under a Board Order.  This is an ongoing problem especially in this economy.  Some employers are refusing to hire a nurse no matter what the basis for the Order.  Most nurses cannot afford to fight an Order [...]]]></description>
			<content:encoded><![CDATA[<p>I have heard from another nurse who is having a difficult time obtaining a job while under a Board Order.  This is an ongoing problem especially in this economy.  Some employers are refusing to hire a nurse no matter what the basis for the Order.  Most nurses cannot afford to fight an Order in court or the facts of the nurse&#8217;s case are such that there is a definite violation and fighting in an administrative law court may not gain the nurse much.  There are some solutions that can help:</p>
<p>1.  Make sure you have malpractice insurance so that you have the financial resources to go to a hearing if you do not agree with the BON&#8217;s decision in your case.</p>
<p>2. When looking for a job, ask everyone you know for help in finding a job.  It tends to be easier to get a job if someone is on the &#8220;inside&#8221; vouching for you and your skills.  There are also employers out there that understand that most nurses with a Board Order are not &#8220;bad&#8221; nurses; that the nurse just made a mistake, or was overworked/understaffed, or had a disease relapse etc.  These employers recognize that most nurses that have had a Board Order become extremely cautious nurses and become definite assets to the facility.</p>
<p>3. Make sure that you have an experienced and BON knowledgeable attorney assist you with your case before the BON so that you get the best outcome possible.</p>
<p>4. You must present a professional appearance (this includes your resume, your social networking site pages, and any application you complete).</p>
<p>5. Contact your state senators and representatives and ask them to make some changes for the next legislative session in 2011.  Some areas that need changes:  expand the corrective action provisions to apply to minor practice violations, allow non-public orders for mental health issues and substance abuse (these are diseases, so why allow the publicity?), allow deferred adjudications to be just that and not be considered a conviction by the BON, and change the language in the NPA from shall to may to allow the BON leeway to make determinations based on mitigating factors.    As 2010 progresses, I will probably think of more&#8230;</p>
<p>I also have more info here:  <a class="alignleft" title="Texas Nursing Jurisprudence" href="http://nursinglaw.blogspot.com/2009/07/how-to-explain-past-board-orders-to.html" target="_blank">http://nursinglaw.blogspot.com/2009/07/how-to-explain-past-board-orders-to.html</a></p>
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		</item>
		<item>
		<title>Temporary Suspension of License for a Postive Drug Screen</title>
		<link>http://www.healthlicensedefense.com/b/2009/12/temporary-suspension-of-license-for-a-postive-drug-screen/</link>
		<comments>http://www.healthlicensedefense.com/b/2009/12/temporary-suspension-of-license-for-a-postive-drug-screen/#comments</comments>
		<pubDate>Tue, 15 Dec 2009 17:45:07 +0000</pubDate>
		<dc:creator>Taralynn Mackay</dc:creator>
				<category><![CDATA[Nurses]]></category>
		<category><![CDATA[addiction]]></category>
		<category><![CDATA[BON]]></category>
		<category><![CDATA[Impairment]]></category>
		<category><![CDATA[substance abuse]]></category>
		<category><![CDATA[temporary suspension]]></category>
		<category><![CDATA[Texas Board of Nurses]]></category>
		<category><![CDATA[Texas Board of Nursing]]></category>
		<category><![CDATA[tpapn]]></category>

		<guid isPermaLink="false">http://www.healthlicensedefense.com/b/?p=65</guid>
		<description><![CDATA[Nurses that are on Board Orders for monitoring due to substance abuse or on a Board Order sending the nurse to TPAPN must be extremely careful with complying with their Board Order and with what they ingest because of the following section of the Nurse Practice Act (taken from the Board&#8217;s website at www.bon.state.tx.us).  There [...]]]></description>
			<content:encoded><![CDATA[<p>Nurses that are on Board Orders for monitoring due to substance abuse or on a Board Order sending the nurse to TPAPN must be extremely careful with complying with their Board Order and with what they ingest because of the following section of the Nurse Practice Act (taken from the Board&#8217;s website at www.bon.state.tx.us).  There is no provision to allow for an explanation that you mistakenly took a medication or that you were only taking cough medicine or whatever explanation is given for the positive screen.  The Board will temporarily suspend your license and then you and your attorney will work on getting the issue resolved and your license unsuspended; so, it is much better to be careful to begin with.</p>
<p><strong><a name="4551">Sec. 301.4551.  Temporary License Suspension for Drug or Alcohol Use. </a></strong></p>
<p>The board shall temporarily suspend the license of a nurse as provided by Section 301.455 if the nurse is under a board order prohibiting the use of alcohol or a drug or requiring the nurse to participate in a peer assistance program, and the nurse:</p>
<p>(1)  tests positive for alcohol or a prohibited drug;</p>
<p>(2)  refuses to comply with a board order to submit to a drug or alcohol test; or</p>
<p>(3) fails to participate in the peer assistance program and the program issues a letter of dismissal and referral to the board for noncompliance.</p>
<p>[Added by Acts 2009 (H.B. 3961), 81st Leg., eff. June 19, 2009]</p>
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		</item>
		<item>
		<title>Impairment Issues before the Nursing Board</title>
		<link>http://www.healthlicensedefense.com/b/2009/12/impairment-issues-before-the-nursing-board/</link>
		<comments>http://www.healthlicensedefense.com/b/2009/12/impairment-issues-before-the-nursing-board/#comments</comments>
		<pubDate>Mon, 07 Dec 2009 16:49:28 +0000</pubDate>
		<dc:creator>Taralynn Mackay</dc:creator>
				<category><![CDATA[Nurses]]></category>
		<category><![CDATA[BON]]></category>
		<category><![CDATA[Impairment]]></category>
		<category><![CDATA[mental illness]]></category>
		<category><![CDATA[substance abuse]]></category>
		<category><![CDATA[Texas Board of Nursing]]></category>

		<guid isPermaLink="false">http://www.healthlicensedefense.com/b/?p=61</guid>
		<description><![CDATA[The Texas Board of Nursing&#8217;s E&#38;D Committee is discussing the following issues today:
1.  Discussion and review of the Board¿s policies and rules relating to physical and psychological evaluations for mental impairment, physical impairment, and/or chemical dependency/abuse of drugs or alcohol, including review and discussion of the Occupations Code §301.4521; 22 Tex. Admin. Code §§213.20, [...]]]></description>
			<content:encoded><![CDATA[<p>The Texas Board of Nursing&#8217;s E&amp;D Committee is discussing the following issues today:</p>
<p>1.  Discussion and review of the Board¿s policies and rules relating to physical and psychological evaluations for mental impairment, physical impairment, and/or chemical dependency/abuse of drugs or alcohol, including review and discussion of the Occupations Code §301.4521; 22 Tex. Admin. Code §§213.20, 213.29, and 213.30; proposed amendments to 22 Tex. Admin. Code §213.33; and the Eligibility and Disciplinary Sanctions for Nurses with Substance Abuse, Misuse, Substance Dependency, or Other Substance Use Disorder.</p>
<p>2. Presentation by Dr. A. David Axelrad, M.D., relating to physical and psychological evaluations, including information regarding objective testing, evaluation criteria, and qualifications of evaluators.</p>
<p>3. Committee recommendations regarding proposed amendments to 22 Tex. Admin. Code §213.33 and guidelines for physical and psychological evaluations for mental impairment, physical impairment, and/or chemical dependency/abuse of drugs or alcohol.</p>
<p>4. Continued discussion and review of SB 1415, enacted by the 81st Legislature, Regular Session, effective September 1, 2009, and Pilot Program on Deferral of Final Disciplinary Actions, including discussion of the feasibility of conducting a pilot program to determine the efficacy of deferring disciplinary actions.</p>
<p>5. Committee recommendations regarding the feasibility of conducting a pilot program to determine the efficacy of deferring disciplinary actions pursuant to SB 1415.</p>
<p>This means that we should see some new rules or guidelines or policies coming from the Board regarding psychological evaluations and something regarding how the Board plans to implement  SB 1415.  So, more to come&#8230;.</p>
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