Link to the Oregon Medical Practice Act
Link to Oregon Administrative Rules
Link to Oregon Nurse Practice Act
Changes to the Oregon Medical Practice Act and Oregon Nurse Practice Act now under consideration by the 2009-2010 Oregon Legislature:
(this page last updated 1/29/2010)
Contact your state legislator and/or Oregon House Health Care Committee Chairman Rep. Mitch Greenlick to let your voice be heard on these important issues involving the future of laws regulating both your profession and YOUR personal healthcare in Oregon. The House Bills (HB's) listed below will change Oregon laws regulating health professionals covered under Oregon licensing boards which include all of the following license types: Medical Doctor (MD), Doctor of Osteopathy (DO), Doctor of Podiatry (DPM), Physician Assistant (PA), Acupuncturist (LAc), Registered Nurse (RN), Licensed Practical Nurse (LPN), Nurse Practitioner (NP), Certified Registered Nurse Anesthetist (CRNA), Clinical Nurse Specialist (CNS), Certified Nursing Assistant (CNA), Certified Medication Aide (CMA), Licensed Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), Licensed Psychologist, Licensed Psychologist Associate, Occupational Therapist, Certified Sex Offender Therapist, Physical Therapist, Physical Therapist Assistant, Licensed Massage Therapist (LMT), Certified Nurse Midwife (CNM), Licensed Direct Entry Midwife (LDM), ...
HB 2059 requires all Oregon health professionals to report one another for "prohibited conduct", which is defined as "conduct involving a person by a licensee that another licensee reasonably believes constitutes grounds for discipline by that licensee's board." This bill was signed into law by Governor Ted Kulongoski on 6/25/2009.
HB 2118 "Imposes a duty on health professionals to report professionals who may be impaired." Section 1 of this proposed 2009 Act further legally defines "impairment" as "an inability to practice with reasonable competence and safety due to the habitual or excessive use of drugs or alcohol, other chemical dependency or a mental health condition." For the purpose of mandatory reporting to health professional licensing boards, HB 2118 does not distinguish between licensees who are suspected of being "professionally incompetent", "guilty of unprofessional or dishonorable conduct", or "may have an impairment." HB 2118 further requires that all Oregon licensees providing mental health services to other Oregon licensees to report clients they suspect may have "an impairment due to a mental disability." Any licensee who is even suspected of having an "impairment", whether or not this "impairment" has ever even allegedly impacted their professional behavior or their professional quality of patient care, will become subject to a mandatory formal investigation. These investigations are routinely conducted by professionals who have a background in law enforcement, and who lack any formal training or certification in public health, mental health, addictive disorders, or civil rights. Health professionals that are subject to these investigations are treated as liars and criminals, are required to sign away all of their constitutionally-guaranteed rights to privacy (including the right to privacy in their own medical and mental health care), and are routinely discouraged from seeking any legal advice or counsel (they are told by the investigators that, "Getting the lawyers involved will just delay your return to work."). By failing to protect their privacy and denying them access to confidential treatment, HB 2118 harms the public health by strongly discouraging health professionals from seeking any kind of professional assistance when they are struggling. HB 2118 unfairly punishes and stigmatizes some members of the public (health professionals) simply for admitting to their human frailty and asking for professional help to maintain their mental health.
Interestingly, in several places HB 2118 explicitly separates physical from mental illness, and serves to further stigmatize mental illness by legally lumping it together with misconduct and incompetence. Section 23 of this 2009 act proposes disciplinary action for, among other things, "unprofessional or dishonorable conduct", "obtaining any fee by fraud or misrepresentation", "conviction of any offense punishable by incarceration", "impairment as defined in section 1 of this 2009 Act", and "gross negligence". In contrast, "physical incapacity" to practice medicine does not automatically trigger a formal licensing board investigation and disciplinary action (the licensee is only required to self-report their incapacity when they have resigned or limited their staff privileges at a health care institution, and "if that action occurs while the licensee is under investigation by the institution or a committee thereof for any reason related to medical incompetence, unprofessional conduct, physical incapacity or impairment [substance misuse or mental health problems]".). Unlike with licensees suspected of mental health problems, HB 2118 also does not require mandatory reporting by healthcare providers of licensees who have "physical incapacity", and these licensees are not automatically required to submit to formal investigation and sanctioning. HB 2118 does not define "physical incapacity", and its legal definition of "impairment" is actually different than the definition provided in HB 2345. [We feel that, on balance, this bill will harm the public health. We oppose the current wording and structure of this bill] This bill was signed into law by Governor Ted Kulongoski on 7/22/2009, and took effect on January 1, 2010.
HB 2345 "Deletes existing impaired professional programs of health profession licensing boards" [including the HPP, which in our opinion should be deleted] and "Directs health profession licensing boards to impose sanctions on impaired professionals." If HB 2345 is passed, all health profession licensing boards in the state of Oregon (physicians, nurses, physician assistants, nurse practictioners, chiropractors, accupuncturists, podiatrists, massage therapists, EMT's, psychologists, professional counselors, etc.) will refer allegedly "impaired" health professionals to a single statewide private "independent monitoring entity", individually contracted by each of the health profession licensing boards, and designed to remove the licensing boards from any future legal liability for (mis)diagnosis, (mis)treatment, and (mis)monitoring of their licensees. HB 2345 also attempts to broaden the scope of existing Oregon impaired professional programs by legally defining "impairment" to include any substance abuse or misuse ("habitual or excessive use or abuse of drugs, alcohol, or other substances that impair ability") without actually defining these terms ("habitual", "excessive", "abuse", "substances that impair ability"). Although previous Oregon statutes have permitted formal sanctioning only for health professionals with a formal psychiatric diagnosis of "chemical dependency" (alcoholism or addiction), in practice the OMB and HPP have taken it upon themselves to formally sanction health professionals with any allegations of substance misuse (even for a single allegation, such as being charged with a DUII; even when allegations are unproven; even when there is absolutely no complaint or evidence of any impairment in the workplace) under the existing statutes. These sanctions can include mandating months or years of treatment costing each licensee tens of thousands of dollars -- along with devastating personal and professional consequences -- for "addictions" that never existed. Now that this practice is finally being challenged in court, state lawmakers are seeking to change existing statutes to make it perfectly legal. [We strongly support the first part of this bill, which deletes many severely dysfunctional existing programs for impaired professionals. However, we strongly oppose replacing these programs with automatic sanctioning for impairment in the absence of licensee misconduct. We also strongly oppose expanding the legal definition for "impairment" to include professionals who do not have active addictions, and to further stigmatize mental health conditions by explicitly lumping them together with “substance abuse or misuse” in the legal definition of "impairment". If mental health conditions must be explicitly included in this definition, then we also strongly support adding physical health conditions that may impair ability to the legal definition of “impairment”. Finally, we would like to ensure that there is some sort of formal professional or legislative oversight in place for the “independent contractors” charged with evaluating and monitoring the treatment of allegedly impaired health professionals, and who under proposed and existing statutes would enjoy absolute immunity from all personal and professional liability related to their conduct, judgment, and practice of medicine in this capacity.] This bill was signed into law by Governor Ted Kulongoski on 7/14/2009, and will take effect on July 1, 2010. As of this date, no health licensing board in Oregon will be permitted to have its own individual health professionals program. Instead, all health regulatory boards that wish to have such a program will be required to send participants to a single centralized Impaired Health Professionals Program (IHPP), which is still being designed and developed by the Oregon Department of Human Services (DHS).
HB 2346 "Limits authority of health professional regulatory boards to conduct mental, physical or competency examinations, assessments or evaluations to cases in which board determines there is objectively reasonable basis for believing licensee or applicant poses danger to patient health or safety. Permits licensee or applicant to request contested case hearing to determine need for mental, physical or competency examination, assessment or evaluation. Provides exceptions permitting immediate conduct of examination, assessment or evaluation." [It's about time!!! We strongly support this affirmation of due process rights for health professionals.] Status update 1/16/2010: This bill has been stalled in the House Health Care Committee since 1/12/2009. As of 1/16/2010, no votes have been taken yet.
HB 2347 "Prohibits health professional regulatory board, Department of Human Services, Oregon Health Licensing Agency or board, advisory council or program overseen by Oregon Health Licensing Agency from assessing costs or attorney fees for disciplinary proceedings." [We strongly support this affirmation of due process rights for health professionals.] Status update 7/23/2009: This bill has been stalled in the House Health Care Committee since 1/15/2009. As of 1/16/2010, no votes have been taken yet.
In October of 2010 the Oregon Medical Board finally revised a longstanding Oregon Administrative Rule which had required automatic suspension of licensees with mental illness treated in a hospital for more than 25 consecutive days (http://www.oregon.gov/OMB/Rules/Oct2009/Final_847-065-0005.pdf).
This page last updated 2/6/2010.