Try to Recognize when an Attorney is Needed

When is it important to hire an attorney in a licensing and criminal defense case? When case agent first contacts you!  Do not talk to them.  Just say thank you, I will call you back; can we meet next week; no you can not come into my house!!
Every day licensing board investigators, police detectives, human resource departments, or other government investigators reach out to targets or “individuals of interest” in a wide range of potential investigations. These law enforcement officers (most state investigators are retired police detectives) are trained to secure statements from the subject of the investigation.  They call you, show up at your house, or try to meet with you at work.  This is when you know you need a lawyer.

My blogs generate phone calls from potential clients.  A recent theme of these calls sticks out;  investigators are employing consistent, heightened and aggressive investigative techniques to surreptitiously secure statements and admissions of criminal conduct, unprofessional licensing behavior, or illegal behavior.  This is explained in one sentence; why do an investigation when an admission from the target will solve the case.

Targets give statements for one reason: ignorance and naïve understanding of the law.   Targets  or potential criminal defendants give statements because they think they are obligated to cooperate, should cooperate, or that cooperating is in their best interest.  These reasons are incorrect.
Admitting to engaging in questionable or criminal conduct eliminates investigator’s obligation and duty of proving their case through means other than an admission by the target.  Admissions to detectives and investigators eliminates their need to perform basic investigator police work.  It satisfies  the police officer’s burden of proof in securing evidence of illegal or criminal conduct against you.
Licensees who admit to a Board investigator to practicing outside the scope of their license, stealing from their clients, overcharging for services, or any other offense does the investigator’s job.  In many cases, before the statement is secured, there is only a mere suspicion of inappropriate behavior.  There is no specific evidence of a criminal act. The statement itself becomes the evidence against you. The person giving the statement creates the criminal evidence for the investigator that they did not otherwise have.   (I feel the same way  about licensees who cooperate in the PHMP VRP assessments.  Do not give the Board’s any evidence they do not have.)
Once a criminal admission is given, the police officers don’t do anymore work. The state investigators don’t do anymore work. This is why there is no legal obligation to cooperate.
Giving statements to employers in work place investigations has the same ultimate result. I have written about this many times. Choosing to not give a blood test, write a personal statement, or even provide copies of medical records cannot be held against you. You can be fired, but it can’t be held against you. At times it’s more important to choose to remain silent then to keep your job.  Anything you say in the employment setting is merely turned over to the board investigator or police.
Remaining silent and not cooperating with any investigation  — not disclosing truly damaging information — sometimes is the best defense of your license or against criminal charges.  Do not succumb to the police officer bullying. Suggestions by police that they can secure search or arrest warrants should not persuade you to give up your constitutional rights.
You do not have to give a statement. You do not have to give a DNA test. You do not have to participate in any polygraph evaluation.   If the officer does not believe your word or accept your version of events, agreeing to provide objective forensic evidence will not change their mind. You will just be giving them evidence to accumulate and use against you at a later date.
Hopefully you have the opportunity to read this blog before you have spoken to an investigator about a licensing issue, participated in the workplace related investigation, or cooperated with any police inquiry inquiry about your job or your behavior. If not, call me as soon as possible.
Whether you hire me or any other lawyer, stop stop cooperating with any police investigation.

What is and is not Psychology?

In preparation for recent hearing, I came across an extremely complex legal topic. The issue is to what extent of can licensees under the Pennsylvania State Board of Social Workers, Marriage and Family Therapists and Professional Counselors  practice their profession short of practicing psychology.

What are these practices?

  • “PRACTICE OF MARRIAGE AND FAMILY THERAPY.” The professional application of psychotherapeutic and family systems theories and techniques to the evaluation, assessment and treatment of mental and emotional disorders, whether cognitive, affective or behavioral. The term includes the evaluation and assessment of mental and emotional disorders in the context of significant interpersonal relationships and the delivery of psychotherapeutic services to individuals, couples, families and groups for the purpose of treating such disorders.
  • “PRACTICE OF PROFESSIONAL COUNSELING.” Includes, to the extent compatible with a practitioner’s education and professional competence, all of the following:
    • (1)  The application of principles and practices of counseling, mental health and human development to evaluate and facilitate human growth and adjustment throughout the life span and to prevent and treat mental, emotional or behavioral disorders and associated stresses which interfere with mental health and normal human growth and development.
    • (2)  The evaluation and assessment of normal and abnormal mental, emotional, social, educational, vocational, family and behavioral functioning throughout the life span; individual, group, family counseling and psychotherapy; crisis intervention, career counseling and educational and vocational counseling; functional assessment of persons with disabilities; and professional consulting.
    • (3)  Professional counselors’ utilization of verbal and nonverbal approaches and specialization in the use of arts-based therapeutic approaches, such as art, dance, music or drama, to accomplish treatment objectives.
  • “PRACTICE OF SOCIAL WORK.” Offering to render or rendering a service in which a special knowledge of social resources, human personality and capabilities and therapeutic techniques is directed at helping people to achieve adequate and productive personal, interpersonal and social adjustments in their individual lives, in their families and in their community or holding oneself out to the public by any title or description of services incorporating the term “social worker” or using any words or symbols indicating or tending to indicate that one is a social worker, except as otherwise provided by this act.

Conversely, the Professional Psychologists Practice Act, 63 Pa. Cons. Stat. § 1203(3) also provides significant guidance.  The Psychologist Act creates a separate exemption for qualified members of other recognized professions including, but not limited to Social Workers, Marriage and Family Therapists and Professional Counselors. This section  1203(3) of the Psychologists Act states:

Nothing in this act shall be construed to prevent qualified members of other recognized professions, including, but not limited to, clergy, drug and alcohol abuse counselors, mental health counselors, social workers, crisis intervention counselors, marriage and family therapists, pastoral counselors, rehabilitation counselors and psychoanalysts, from doing work of a psychological nature consistent with the training and the code of ethics of their respective professions or to prevent volunteers from providing services in crisis or emergency situations. This exemption applies only to the practice of the respective listed profession.

So, what is practicing Psychology?  “Practice of psychology” means offering to render or rendering to individuals, corporations, institutions, governmental agencies, or the public for remuneration any service involving the following:

(i) The application of established principles of learning, motivation, perception, thinking, and emotional relationships to problems of personality evaluation, group relations, and behavior adjustment. The application of said principles includes, but is not restricted to, counseling and the use of psychological methods with persons or groups with adjustment problems in the areas of work, family, school, and person?-1 relationships; . measuring and testing· of personality, intelligence, aptitudes, and emotions, and offering services as a psychological consultant.

(ii)(a) “Measuring and testing,” consisting of the psychological assessment and evaluation of abilities, attitudes, aptitudes, achievements, adjustments, motives, personality dynamics and/or other psychological attributes of individuals, or groups of individuals by means of standardized measurements or other methods, techniques or procedures recognized by the science and profession of psychology, (b) “psychological methods,” consisting of the application of principles of learning and motivation in an interpersonal situation with the objectives of modification of perception and adjustment, and requiring highly developed skills in the disciplines, techniques, and methods of altering through learning processes, attitudes, feelings, values, self-concept, personal goals· and adaptive patterns, ( c) “psychological consulting,” consisting of interpreting or reporting upon scientific fact or theory in psychology, rendering expert psychological opinion, psychological evaluation, or engaging in applied psychological research.

This definition contains numerous elements, which can be broken down as follows: (1) the practitioner offers to render or renders (2) to individuals, corporations, institutions, governmental agencies, or the public (3) for remuneration ( 4) any service involving one or more of the following:

(a) the application of established principles of learning, motivation, perception, thinking, and emotional relationships to problems of personality evaluation, group relations,, and behavior adjustment, which established principles include measuring and testing of personality, intelligence, aptitudes, and ’emotions, and offering services as a psychological consultant; or (b) psychological assessment and evaluation of abilities, attitudes, aptitudes, achievements, adjustments, motives, personality dynamics and/or other psychological attributes of individuals by means of standardized measurements or other methods, techniques or procedures recognized by the science and profession of psychology; or (c) “psychological consulting,” consisting of interpreting or reporting upon scientific fact or theory in psychology, rendering expert psychological opinion, psychological evaluation, or engaging in applied psychological research.

In applying these definitions to the exemptions, 49 Pa. Code § 41.7 incorporates a statement of policy that provides guidelines for determining whether a given group qualifies as a “recognized profession” for the purposes of section 63 P .S. § 1203(3). Those guidelines read as follows:

(1) The group’s activity and focus must be based on an identifiable body of theoretical knowledge which, although it may include areas of coII1I11on knowledge shared with psychology, is demonstrably different, in the aggregate, from the body of theoretical knowledge underlying psychology.
(2) The group must regulate entrance into professional membership by means of standards of knowledge, training and proficiency generally accepted by the profession with which it identifies.
(3) ) . The group’s activity must be guided by generally accepted quality standards, ethical principles and requirements for an independent profession.
(4) The group must exhibit the ordinary accoutrements of a profession, which may include, but are not limited· to, professional journals, regional and national conferences, specific academic curricula and degrees, continuing education opportunities, regional and national certification and awards for outstanding practice within the profession.

More importantly, Section 1203(3) does not absolving these other licensed professionals from the prohibition against holding themselves out to the public by any title incorporating the words “psychological,” “psychologist” or “psychology” without first obtaining a license to practice psychology pursuant to the act.  The blanket advertising limitation set forth in section 1203 states:

It shall be unlawful for any person to engage in the practice of psychology or to offer or attempt to do so or to hold himself out to the public by any title or description of services incorporating the words “psychological,” psychologist” or “psychology” unless he shall first have obtained a license pursuant to this act, except as hereinafter provided:

Pursuant to the Ethical Principal 4(b) of the board’s regulations, “only psychologists licensed by a state board of psychologists examiners may be listed under the heading of psychologists in the yellow pages of the telephone directory.” 49 Pa. Code § 41.61.

Dezen v. Bureau of Prof’l & Occupational Affairs, 722 A.2d 1135 (Pa. Commw. Ct. 1999) discussed this issue. Dezen, a licensed social worker advertised in the Yellow Pages his ability to provide psychological counseling and similar services. The board found that he was not licensed as a psychologist and could not advertise his testing services as such.  The case law clearly precludes any other licensed professionals from holding themselves out to the public by any title or description of services incorporating the term using any words or symbols indicating portending to indicate that he or she his license or authorized to practice in any other capacity send their specific licensed professional.

Call me to discuss your case.

 

A Harsh Disciplinary Enforcement Environment for Pennsylvania Licensees

I write this blog in preparation for a Pennsylvania Nursing Board ordered Mental and Physical Examination (“MPE”) of a client.   It is startling the number of these board ordered evaluations or PHMP/PHP/PNAP assessments due to some type of licensee criminal conduct.  The heightened disciplinary activity among all boards reveals a much stricter atmosphere of licensee disciplinary enforcement.  Why?
Pennsylvania’s heightened disciplinary environment is based upon a single legislative occurrence and a single judicial decision.  Legislatively, passage of Pennsylvania’s medical marijuana regulatory scheme has prompted a review of all licensing laws in anticipation of increased licensee impairment and criminal activity due to marijuana usage (legal or not).
A prime example of this is Senate Bill 354 of 2017.  I wrote about this bill last week.  This bill seeks to compel any licensee charged with a crime (not convicted) to report such to their respective licensing board within 30 days of arrest.  Failure to report will constitute a separate basis for discipline.  This Bill seeks to bring the boards’ immediate knowledge of licensee’s criminal conduct so discipline can commence sooner.
Pennsylvania’s licensing boards subscribe to JNET – Pennsylvania’ criminal fingerprint data base.  The Boards already know of licensee’s criminal charges of which they already expect them to report upon conviction.  However, the Boards now want quicker reporting, with an additional and stronger basis for discipline.  False reporting and failing to report criminal conduct!!
But this bill is not not law.  So what’s the juice?  The juice is that current licensee’s facing disciplinary action for some really minor issues will think twice before smoking pot; they will tell their friends and co-workers to think twice before smoking pot and taking care of the public.  The health related boards are gearing up prosecutors for stricter supervision of all licensees.  In this conservative jurisdiction, pot is thought to be a gateway drug to heroin.  The prescription based opiate epidemic caught the health related boards with their pants down.  It will not happen again with the passage of medical marijuana.
The enforcement environment also extends to potential licensees enrolled in any health related school who apply for licensure with a criminal history of one or two DUI’s.  I represent many individuals whose licensure applications have been stalled based upon conditional denials and compelled PHMP enrollment.   A new regulation requiring  license applicants to be licensed within 12 months of taking their board examinations aides the Board in weeding out potential applicants who do not accept PHMP enrollment.
DO NOT go willy-nilly to the PHP/PHMP assessment and or evaluation with the expectation that you will pass and be given your license.  DO NOT answer the personal data sheet with out consulting an attorney.  DO NOT talk to the PHMP intake or assessors without attorney preparation.  They write everything down — your story of depression, injured or dead family members, your divorce, your child abuse history.  The PHMP people will always recommend enrollment in the VRP after you, the new licensee, admit your mental health treatment, drug use, and inability to practice safely.   How can you admit you can not practice safely if you have never practiced?  Applicants fighting their cases must be patient and call me ASAP. 
The Birchfield decision (written about in other blogs) is the judicial decision most affecting disciplinary actions.  Birchfield focused on the admissibility of blood alcohol levels as a result of a non-consensual blood draw in a DUI investigation. This case has rippled through every Pennsylvania county’s drunk driving enforcement efforts.  Birchfield ruled inadmissible DUI blood evidence that revealed drugs (illegal or prescription) and/or marijuana use.
Birchfield rendered blood drug use evidence an inappropriate basis for licensee disciplinary action.  The heightened reporting responsibilities of nurses (30 days from arrest), allow petitions for mental and physical evaluations based upon affidavits of probable cause reflecting alcohol or drug use even though blood evidence is not admissible in a court of law.  The Boards want to know right away what its licensees are smoking or drugs they are ingesting.
Pennsylvania licensees need to fight every criminal case. The new notice provisions in Bill 354 will become law.  While criminal charges are pending licensees will have to provide a potentially incriminating personal statement to a licensing board.  This is crazy.  There is no 5th Amendment right against self-incrimination in a professional license defense.  Licensees need an attorney to help draft counseled answers to strategic legal questions and statements under these circumstances.  Now, more than any time in the recent past, licensees should utilize counsel to properly protect their license.
The Boards use their experts to determine impairment.  Why shouldn’t you use your expert to protect your license?  Licensees face workplace challenges, complex life issues, and now a crazy enforcement environment in Pennsylvania.    Mail from the PHMP, PHP, and PNAP present multi- faceted traps for even the most experienced licensees.  Licensee need their own expert — an experienced criminal and administrative law attorney to effectively protect their license.  Call me to discuss your criminal or license case.

Proposed Pennsylvania Law for All Licensee’s Criminal Charge Reporting Responsibilities

In February several Pennsylvania state senators introduced Senate Bill number 354 of 2017. This bill drastically changes licensees reporting responsibilities once they are charged with a crime. Currently, most licensees (Except nurses) must report a criminal charge only upon conviction. Senate Bill 354 as currently written specifically states:

Section 2.1.  Reporting of sanctions and criminal proceedings.

(a)  Duty.–An individual who holds a license, certificate or registration issued by the Bureau of Professional and Occupational Affairs shall, as a condition of licensure, certification or registration, do all of the following:

(1)  Report to the appropriate licensing board or licensing commission a disciplinary action taken against the licensee, certificate holder or registrant by a licensing agency of another jurisdiction.

(2)  Report to the appropriate licensing board or licensing commission an arrest, indictment or conviction of the licensee, certificate holder or registrant.

(b)  Time.–A report under subsection (a) shall be made as follows:

(1)  Within 30 days of the imposition of the sanction described under subsection (a)(1).

(2)  Except as set forth in paragraph (3), within 30 days of the earlier of:

(i)  an arrest under subsection (a)(2); or

(ii)  an indictment under subsection (a)(2).; or

(iii)  a conviction under subsection (a)(2).

(3)  In the case of a criminal action under subsection (a)(2) that is initiated prior to the effective date of this paragraph, within 30 days from the later of:

(i)  the date of conviction; or

(ii)  the effective date of this paragraph.

If a licensee does not report a new arrest within 30 days, the licensee is subject to additional disciplinary action.

All Pennsylvania licensees may soon become subject to disciplinary action as a result of accused, not convicted, criminal conduct.  This is a much different from the current scenario of disciplinary action upon conviction. The remaining subsection identified below is consistent with current procedural due process rights to a licensee whose license is subject to an immediate clear and present danger emergent suspension.

(a)  Temporary suspension.–A licensing board or licensing commission may temporarily suspend a license, certificate or registration under circumstances as determined by the board or commission to be an immediate and clear danger to the public health and safety. The board or commission shall issue an order to that effect without a hearing, but upon due notice, to the licensee or, certificate holder or registrant concerned at his last known address, which shall include a written statement of all allegations against the licensee or, certificate holder or registrant. After issuing the order, the board or commission shall commence formal action to suspend, revoke or restrict the license or, certificate or registration of the person concerned as otherwise provided for by law. All actions shall be taken promptly and without delay.

(b)  Hearing.–Within 30 days following the issuance of an order temporarily suspending a license, certificate or registration, the licensing board or licensing commission shall conduct or cause to be conducted a preliminary hearing to determine whether there is a prima facie case supporting the suspension. The licensee or, certificate holder or registrant whose license or, certificate or registration has been temporarily suspended may be present at the preliminary hearing and may be represented by counsel, cross-examine witnesses, inspect physical evidence, call witnesses, offer evidence and testimony and make a record of the proceedings. If it is determined that there is not a prima facie case, the suspended license, certificate or registration shall be immediately restored. The temporary suspension shall remain in effect until vacated by the board or commission, but in no event longer than 180 days.

(c)  Automatic suspension.–A license or, certificate or registration issued by a licensing board or licensing commission shall automatically be suspended upon:

(1)  the legal commitment to an institution of a licensee or, certificate holder or registrant because of mental incompetency for any cause upon filing with the board or commission a certified copy of the commitment; or

(2)  conviction of a felony under the act of April 14, 1972 (P.L.233, No.64), known as The Controlled Substance, Drug, Device and Cosmetic Act, or conviction of an offense under the laws of another jurisdiction which, if committed in this Commonwealth, would be a felony under The Controlled Substance, Drug, Device and Cosmetic Act.

(d)  Stay.–Automatic suspension under subsection (c) shall not be stayed pending an appeal of a conviction.

(e)  Restoration.–Restoration of a license or, certificate or registration shall be made as provided by law in the case of revocation or suspension of the license or, certificate or registration.

New to the licensing and regulatory scheme for every licensee is the ability of a licensing board to automatically suspend a license if the licensee is committed to a mental health facility for any reason or a conviction under the Drug Act. Restoration of the licensees license suspended under Senate Bill 354 shall be consistent with any other procedural due process rights.
Please call me to discuss your case

A Really Nice Client Review

“I was caught completely off guard this past fall when after attending a concert with some friends I received a DUI. It was the first driving offense I had received in 40 years and I felt very bad about it happening. What I did not expect however, was that within 48 hrs, I received notice from the State Board of Nursing, that I needed to sign some documents stating that I would enter into a program that they run for alcoholics and if I didn’t sign, I would lose any chance of saving my nursing license in the future if I was found guilty. I have no words for how devastated I felt. I have been in nursing for 38 yrs without so much as a verbal correction. I had no idea, that the DUI would result in the loss of my professional license. I was completely terrified. So, knowing that I was not guilty of being an alcoholic and have no history whatsoever of any type of substance abuse at home or work, I signed the papers, thinking they would support me. Well, it was quite the opposite. They way their system is set up, once you sign the papers, they say that you are guilty. Thank God, I have a good friend, who knew me well, and began researching this process since it didn’t make sense to her. She found Richard Hark and told me that I needed to see him immediately. I hope that if you have found your way to this page through your own research, you will go to talk to him. He took extremely good care of me and my case was closed. I was wrong to get a DUI, but to lose my nursing license was not fair. I am getting ready to retire in a few months and I asked my supervisor if I could give an inservice to the other nurses, explaining to them, the unfair practices that are out there. Best to anyone who reads this.”

 

Please call me if you feel like this.

To Testify or Not – A Licensee’s Hearing Rights

The confluence of administrative and criminal procedure is a significant issue I confront defending licensee disciplinary cases.  Sometimes, during a hearing, or a pre-complaint investigatory meeting, a licensee is asked — almost expected — to give a statement.  During a hearing, with a criminal case pending, a licensee sometimes must strategically choose or not to testify.  This issue was recently addressed in the case of Blair Anthony Hawkins v. Bureau of Prof’l & Occupational Affairs, 2017 Pa. Commw. Unpub. LEXIS 112 (Commw. Ct. Feb. 16, 2017).

In that matter, after the Department presented its evidence, Hawkins argued that the Board denied him a full and fair hearing when it failed to continue the hearing until after the resolution of the criminal case, thus resulting in Hawkins’ decision to invoke his Fifth Amendment right against self-incrimination before the Board.  However, Hawkins was not forced to testify.  Hawkins invoked his 5th Amendment Rights against self-incrimination.

A hearing was held on January 8, 2016, at which Petitioner renewed his request for a continuance until after the criminal charges were resolved. The Board denied the continuance request. Therefore, Hawkins asserted his Fifth Amendment right against self-incrimination and did not answer any questions.  This looks horrible in a hearing.

Prior to the hearing, the parties exchanged pre-hearing statements, identified witnesses and exhibits, and participated in a pre-hearing conferences. On the day before the hearing, Petitioner requested a continuance via email, until Hawkins’ criminal charges were resolved. The Department opposed the continuance request. The Board denied the continuance, noting that Petitioner had previously been granted a continuance, had indicated that he was available for the hearing on January 8, 2016, had participated in a pre-hearing conference a few days prior, and had failed to identify an emergent reason for requiring a continuance.

Initially, the continuance request was handled improperly.  Either at a pre-hearing conference, or in a separate motion to continue the hearing, counsel for Hawkins should have sought a continuance much sooner, with greater vigor.  Counsel, not Hawkins, put his client in the trap the licensee board prosecutors set.  The Board prosecutor set the trap, showed the trap to counsel, and counsel messed up the case.  The matter should have been continued way before the hearing until after the criminal case had resolved.

In reviewing the choice to testify or not, the Board looked to prior case law.  In Herberg v. Commonwealth, State Board of Medical Education & Licensure, 42 A.2d 411, 412 (Pa. Cmwlth. 1982), a physician’s medical license was revoked and the physician argued that during the hearing before the board, his rights pursuant to the Fourteenth and Fifth Amendments of the United States Constitution were violated. The physician invoked his Fifth Amendment right against self-incrimination so that his testimony before the board could not be used in a later criminal proceeding.  Commonwealth Court determined that:

‘[T]here [is nothing] inherently repugnant to due process in requiring the doctor to choose between giving testimony at the disciplinary hearing, a course that may help the criminal prosecutors, and keeping silent, a course that may lead to the loss of his license.'[A]bsent a finding that a physician was forced to testify against himself, a medical disciplinary board was not constitutionally required to stay its proceedings until the criminal prosecutions against the doctor were over.

In Hawkins, the licensee was called as a witness, chose not to testify, and was not forced to testify. Thus, Hawkins’ Fifth Amendment right against self-incrimination was not violated because the Board honored his choice not to testify. Further, due process rights are not violated simply because a decision on whether to testify is arduous. See PSI Upsilon v. University of Pennsylvania, 591 A.2d 755, 760 (Pa. Super. 1991). Hawkins made what was assuredly a hard decision not to testify; however, making this decision did not result in a violation of his due process rights. See Herberg, 42 A.2d at 413. The Board did not err or abuse its discretion when it held Hawkins’ disciplinary hearing prior to his criminal proceeding, thus making Hawkins choose between testifying or asserting his privilege against self-incrimination.

Call me to talk about your case, investigators wanting you to give a pre-complaint statement, and how to handle your up coming hearing.

 

A Refresher on Unprofessional Conduct in Pennsylvania as it Relates to Convictions for Assault

In preparation for every hearing, I review case law discussing the relevant legal issues.  One such recurrent topic is unprofessional or immoral conduct.  This is the vague Pandora’s box of behavior upon with both license revocation and denial may be based.  What is immoral conduct as it relates to physical fighting and the crime of assault.

One clear case involves a licensed social worker who pleaded guilty to two counts of simple assault, which is a 2nd degree misdemeanor.  The criminal charges arose from the licensee assaulting a former client and the client’s husband. The criminal complaint alleged that counselor had engaged in an affair with the former client and that upon traveling to the former client’s home, she attacked K and T.  The conduct resulted in convictions, for which the Board issued an Immediate Temporary Suspension order (ITS).  This is immoral conduct.  Do not go and assault a former client for anything, let alone braking of a relationship and returning to their spouse.

Another case is Foose v. State Board of Vehicle Manufacturers, Dealers and Salespersons, 135 Pa. Commw. 62, 578 A.2d 1355 (Pa. Cmwlth. 1990), where the Court defines crimes of moral turpitude as “anything done knowingly contrary to justice or good morals.” Foose, 578 A.2d at 1357.  Assault convictions fall within this definition because assaults “are inconsistent with the definition of good moral character [and they] involve a reprehensible state of mind.” “The reprehensible state of mind” at issue with the misdemeanors of which any licensee is convicted “is the knowing or reckless attempt to cause or causing bodily injury to another, or engaging in conduct which constitutes a physical menace intended to put another in fear of serious bodily injury.” A conviction for 1st or 2nd degree assault means you intentionally inflicted bodily injury upon that person.  Your license could be assaulted by the board for such conduct…..don’t let them do it so don’t you do it.

Sometimes a Board will distinguish third-degree misdemeanor simple assault, which involves conduct that may be lacking in a “reprehensible state of mind” that could arise in a situation such as “a fight or flight scuffle by mutual consent.” However, other Boards have been persuaded that intentional appearance at a victim’s home to conduct an assault constitutes a crime of moral turpitude. It is a reasonable interpretation and the appellate courts have concluded such.

In another case involving a teacher and his wife, the governing regulations provided that the only relevant inquiry when questioning whether a crime is one of moral turpitude relates to the particular elements of the crime committed, not to the facts underlying the particular commission of the crime. The regulatory provision at issue, 22 Pa. Code § 237.9(a), provided guidance, defining “moral turpitude” as including “reckless conduct causing bodily injury to another.” Importantly, many professional licensing regulations do not include this specific inclusive language.

Although the definition in the teacher regulations also included “conduct done knowingly contrary to justice, honesty or good morals,” some courts have opined that the term “moral turpitude” as defined in the regulation, as well as the definitions arising in other statutory contexts requires a reprehensible state of mind or mens rea. Thus, it may be an “act of baseness, vileness, or depravity, contrary to the accepted customary rule of right and duty between two human beings.” Such an act requires at least knowledge of private impropriety or the potential for social disruption. Also an act of moral turpitude may consist of intentional, knowing or reckless conduct.  A teacher, hitting his spouse, has been interpreted as depraved conduct warranting licensing revocation or discipline.

In sum, do not assault your partner, your friends, your current or former clients, and especially, strangers.  Call me to discuss your case and any criminal conviction.

 

 

 

 

PHMP — Pennsylvania — How It Really Works

Here is an email I received this week

RN w a PA license started pnap program 4 yrs ago and they will not let me out if the program. I fulfilled all the requirements and I’m over the amount of time stated in my contract. Every months they come up w something new and threaten to add another year to three. They also threaten if I contact a lawyer I can kiss my license goodbye and I truly believe they have the power to do anything at this point.

They treat me as if I have a substance abuse and test me relentlessly and at one point bc of ice n snow I missed testing they cut my hair and did hair analysis which was negative. In four years I have never had a positive test. And that’s w 1,2,3,4 times testing. Month. I was supposed to be released in November 2016 I missed a call in the day I was leaving for the beach. Packing for 6 kids 10yo and younger for a week distracted me a bit. That is when they threatened to add 3. More yrs for noncompliance. I’m already over my time! Yesterday I could not make a test bc 3 of my kids were vomiting and Had high fevers I could not drag them out w out torturing them. So again I’m getting threatened w more time ands or never seeing my license again. I went I to this program thinking they were here to help me. Obviously they are here for the $$ and to make near impossible to complete the program. I’m stuck. They have taken all the money I have. No I’m finding out it’s not the pnap making the calls it’s the testing company.

This is email presents legal issues about which I receive calls every week.  This email is reflective of the PHMP and PNAP, how the treat their enrollees in the program.  Read this email again before signing any documents and call me.

More importantly, understand the exploding opiate addiction pain medication problem our cities, states, rural areas, and country is facing.  Stepped up offering and then enforcement of the impair professional program, and all of its terms and conditions, is reflected in the statistics a recent news article discussed. Video of ABC News Investigation

However, the statistics cited int he article,73% of all disciplinary cases are for drug and impairment issues, only reflects the stepped up threats, coercion, and intimidation the program administrators are using in convincing people to go into the program that some do not really need.  Read my many other blogs discussing how single offense DUIs, Public Drunkenness, and other minor infraction are brought tot he Board’s attention, resulting in PHMP and PNAP “Letters of Concern” being sent to professionals and scaring them into the program.

Call me to discuss your case.

 

 

 

 

Pennsylvania’s New Physician Licensing Compact

In November of 2015 I blogged about the proposed version of Pennsylvania’s Interstate Medical Licensure Compact Act.  One year later, effective October 26, 2016, the Act has become Law. What does this mean for Pennsylvania’s physicians?

The Interstate Medical Licensure Compact Act (the “Act”) only applies to “Physician”, a person who:
1. is a graduate of a medical school accredited by the Liaison Committee on Medical Education, the Commission on Osteopathic College Accreditation or a medical school listed in the International Medical Education Directory or its equivalent;
2. passed each component of the United States Medical Licensing Examination or the Comprehensive Osteopathic Medical Licensing Examination within three attempts or any of its predecessor examinations accepted by a state medical board as an equivalent examination for licensure purposes;
3. successfully completed graduate medical education approved by the Accreditation Council for Graduate Medical Education or the American Osteopathic Association;
4. holds specialty certification or a time-unlimited specialty certificate recognized by the American Board of Medical Specialties or the American Osteopathic Association’s Bureau of Osteopathic Specialists;
5. possesses a full and unrestricted license to engage in the practice of medicine issued by a member board;
6. has never been convicted, received adjudication, deferred adjudication, community supervision or deferred disposition for any offense by a court of appropriate jurisdiction;
7. has never held a license authorizing the practice of medicine subjected to discipline by a licensing agency in a state, federal or foreign jurisdiction, excluding an action related to non-payment of fees related to a license;
8. has never had a controlled substance license or permit suspended or revoked by a state or the United States Drug Enforcement Administration; and

9. is not under active investigation by a licensing agency or law enforcement authority in a state, federal or foreign jurisdiction.

Upon receipt of an application for an expedited license, the member board within the state selected as the state of principal license shall evaluate whether the physician is eligible for expedited licensure and issue a letter of qualification, verifying or denying the physician’s eligibility to the interstate commission. The following shall apply:
1. Static qualifications, which include verification of medical education, graduate medical education, results of any medical or licensing examination, and other qualifications as determined by the interstate commission through rule, shall not be subject to additional primary source verification where already primary source verified by the state of principal license.
2. The member board within the state selected as the state of principal license shall, in the course of verifying eligibility, perform a criminal background check of an applicant, including the use of the results of fingerprint or other biometric data checks compliant with the requirements of the Federal Bureau of Investigation, with the exception of federal employees who have suitability determination in accordance with 5 C.F.R. § 731.202 (relating to criteria for making suitability determinations).
3. Appeal on the determination of eligibility shall be made to the member state where the application was filed and shall be subject to the law of that state.

 

An important part of the Act is the joint investigation and disciplinary process. The law as enacted states:

ARTICLE IX JOINT INVESTIGATIONS
A. Licensure and disciplinary records of physicians are deemed investigative.
B. In addition to the authority granted to a member board by its respective Medical Practice Act or other applicable state law, a member board may participate with other member boards in joint investigations of physicians licensed by the member boards.
C. A subpoena issued by a member state shall be enforceable in other member states.
D. Member boards may share any investigative, litigation or compliance materials in furtherance of any joint or individual investigation initiated under the compact.
E. Any member state may investigate actual or alleged violations of the statutes authorizing the practice of medicine in any other member state in which a physician holds a license to practice medicine.
ARTICLE X DISCIPLINARY ACTIONS
A. Any disciplinary action taken by any member board against a physician licensed through the compact shall be deemed unprofessional conduct which may be subject to discipline by other member boards, in addition to any violation of the Medical Practice Act or regulations in that state.
B. If a license granted to a physician by the member board in the state of principal license is revoked, surrendered or relinquished in lieu of discipline, or suspended, then all licenses issued to the physician by member boards shall automatically be placed, without further action necessary by any member board, on the same status. If the member board in the state of principal license subsequently reinstates the physician’s license, a license issued to the physician by any other member board shall remain encumbered until that
respective member board takes action to reinstate the license in a manner consistent with the Medical Practice Act of that state.
C. If disciplinary action is taken against a physician by a member board not in the state of principal license, any other member board may deem the action conclusive as to matter of law and fact decided, and:
1. impose the same or lesser sanction(s) against the physician so long as such sanctions are consistent with the Medical Practice Act of that state; or
2. pursue separate disciplinary action against the physician under its respective Medical Practice Act regardless of the action taken in other member states.
D. If a license granted to a physician by a member board is revoked, surrendered or relinquished in lieu of discipline, or suspended, then any license(s) issued to the physician by any other member board(s) shall be suspended, automatically and immediately without further action necessary by the other member board(s), for ninety (90) days upon entry of the order by the disciplining board, to permit the member board(s) to
investigate the basis for the action under the Medical Practice Act of that state. A member board may terminate the automatic suspension of the license it issued prior to the completion of the ninety (90) day suspension period in a manner consistent with the Medical Practice Act of that state.

Any disciplinary action taken by the physician’s principle licensing board (their home state) shall, under House Bill 1619 of 2015, be deemed unprofessional conduct subject to discipline by other member boards in addition to any violation of the Medical Practices Act or regulations of the principle state. Revocation, suspension, or surrender of a license in lieu of discipline or suspension shall cause the physician’s license to suffer similar status by each and every member board to which that physician is licensed.

Conversely, however, any reinstatement of the physician’s license by his principal state medical board shall not affect the encumbered status of that physician’s license in other member states unless and until each member state takes individual action to reinstate my license. This provision allows each member board to conduct the practice of their medical board license disciplinary action independent of the Act. This process is different the current due process rules that require each state’s discipline of a multiple state licensed professional to be independent of, and not link to, any prior state’s discipline.

Any discipline action taken by the physician by a member board, not the principal license board, may be used by other member boards as a conclusive disciplinary action warranting imposition of the same or less or sanction or a separate disciplinary action by other member boards. As well, any license investigation by a member board that becomes the subject revocation, surrender or relinquishment in lieu of discipline shall cause the physician’s license to suffer the same consequences without any further action in each other member board without the subject to any disciplinary investigation. The physician truly becomes hostage to the initiating state’s disciplinary process and must fight it to the death so as to avoid any automatic domino effect.

The Act seeks to balance the states’ citizens’ need for medical care, a nation’s policy interest in granting access to high quality medical care to all citizens, and a physician’s ability to provide competent medical service regardless of artificial state borders against patient safety and criminally active doctors. The primary concern of the Act is who will become the disciplinary supervisor of doctors practicing throughout the country under the Act. While this is a serious and weighty issue, the Act in its current form fails to safeguard the medical license of Pennsylvania’s many doctors who will choose it as their primary state of licensure.

Pennsylvania’s medical schools have produced thousands of doctors over the years. Many secure initial graduate school training licenses and stay in the Commonwealth after residency to care for Pennsylvania’s residents. Many choose Pennsylvania as a home. The Act as drafted in House 1619 of 2015 will discourage this.

Physicians who seek to practice medicine in multiple states through the Act will sacrifice a significant degree of due process if any disciplinary investigation is commenced or levied against them. While there is significant financial interest to provide internet-based face time oriented medical practice across state borders without driving distances, to save lives, the inevitable due process concerns are significant. Exploding populations are overrunning medical investigatory boards with rampant anonymous complaints that will warrant investigation.

Every day baseless complaints of Medicare Medicaid insurance fraud, pill mills, sexual assaults, or drug theft and diversion are generated from specious reporters who are either aggrieved patients, angry disgruntled business partners, jealous or angry co-employees, or scorned lovers. House Bill 1619 of 2015 exposes Pennsylvania’s principle-based medical practitioners to unilateral concurrent disciplinary process of member states without the ability to respond, investigate, or even defend oneself in a court of law. Member state’s unilateral actions will automatically trickle back to the physician’s primary licensure state, causing potentially automatic disciplinary action there. The Act as written is not in the interest of Pennsylvania medical community.

PHMP’s NEW TRICK – License Inactive Documents

Pennsylvania’s monitoring program, PHMP has instituted a new trick in their playbook. Now, with every PHMP questionnaire and data sheet, PHMP/PNAP caseworkers are including a voluntary license inactivation document. WHAT IS THIS? DON’T SIGN IT.

This is a new attempt to limit voluntary recovery program (“VRP”) participants from changing their mind before the Board enters a consent agreement formally accepting them into the VRP. In essence, most potential monitoring program targets/enrollees are actually INeligible for the VRP. Most do not suffer from any drug or alcohol addiction that renders them unable to perform their profession.  The caseworkers just pressure them to admit this.

These VRP participants, however, mistakenly sign the contract, get stuck with a false bills of goods, contact counsel and seek to change their minds. I TELL ALMOST EVERYONE TO WITHDRAW FROM THE PROGRAM, DO NOT ADMIT TO ANY IMPAIRMENT AND FIGHT FOR THEIR MEAL TICKET.  NEVER ADMIT ANY IMPAIRMENT.

If the licensee signs this new form, voluntarily rendering their license inactive, there is no point in changing their mind to go back to work. They can’t because their license is now inactive.  Formal Board action is required to reactivate that license. While the same PHMP Mental and Physical evaluation (SEE MY OTHER BLOGS) will take place, the licensee now cannot work during this 3-7 MONTH process. This is compared to not signing the form, not going into the program, fighting the case, and working pending the PHMP evaluation with an expert, not a cracker jack box assessor!

My prior blogs discuss why almost every licensee should not voluntarily enroll in the monitoring program. The blogs discuss the burdens of proof and difficulty of complying with all confirms and conditions of the monitoring program. GO READ THEM.

Importantly, there is a 6-8 MONTH time lag between the initial PHMP/PNAP “letter of concern” contact with the licensee and when a formal signed board approved consent agreement binds a licensee into the PHMP. Remember, this is a voluntary process. Prior to an executed professional license board FORMAL consent agreement being entered, EVERY licensee (doctor, nurse, pharmacist) is free to change their mind and withdraw from the program.

If a licensee signs a voluntarily inactive agreement, the program is no longer voluntary. If the licensee signs a voluntary license inactive document, changing their mind and withdrawing from the PHMP — because of the bait and switch tactics of the caseworkers quickly reveal themselves — signing an agreement to have a license deemed inactive handcuffs the licensee into the program.

Remember,  the VRP is just that; voluntary. Every licensee must acknowledge a drug or alcohol addiction and that renders them incapable of safely practicing their profession. If a licensee does not suffer from a potential drug or alcohol abuse or dependence disorder and/or are capable of safely practicing your profession, DON’T SIGN ANY DATA QUESTIONNAIRE, PHMP CONTRACT AND, ESPECIALLY, AN AGREEMENT TO VOLUNTARILY RENDER A LICENSE INACTIVE. Once the license is inactive, whether you change your mind about the program or not, withdrawing from the program does not allow a licensee to work.

That’s another important aspect of these PHMP contracts. PHMP/PNAP/PHP/SARPH agreements require licensees agrees to abide by any terms and conditions imposed by their caseworker. Some caseworkers compel not working in the licensee’s profession for a short period of time. Nonetheless, previously, the license was still active. Now, if a licensee signs that inactive agreement, the caseworker has ultimate control over the licensee, their career, their profession, and their wallet.

The case worker has the licensee’s professional career by the neck and will not let go until licensee completely satisfy them. TRUST ME, THE CASE WORKER AND PHMP case managers are not and never act as the licensee’s “advocate.” Their allegiance is to the board, their job, and their pay check, not the licensee’s.

With a license inactive, the caseworker must file a formal board document asking for re-activation prior to even them even being able to permit the licensee to work (even when in the PHMP). The Boards sit on these requests for multiple months.  As such, these voluntary inactive documents further extend and strengthen the caseworkers’ control over the licensee. It is inappropriate, unacceptable and could be deemed it illegal to compel a licensee to sign a interactive document as part of PHMP contract.

Remember, enrollment in the PHMP does not constitute discipline of a license. Only after the Board accepts the PHMP contract in the form of a consent agreement has discipline been entered. Opting out of the PHMP prior to Board approval does not constitute discipline and the licensee’s license is not restricted in any manner. If the licensee withdrawals from the PHMP and has not signed any license inactive document, they can go to work right away.

If the licensee agrees to sign the interactive document request, there’s no difference between withdrawing from the PHMP or not, as they will not be able to work until the license is reactivated. DON’T SIGN THIS NEW DOCUMENT WITHOUT LEGAL COUNSEL. DON’T SIGN THIS DOCUMENT UNDER ANY CIRCUMSTANCES, NO MATTER WHAT.

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