Blair v. Bureau of Professional & Occupational Affairs

72 A.3d 742, 2013 WL 3865102, 2013 Pa. Commw. LEXIS 276
CourtCommonwealth Court of Pennsylvania
DecidedMay 22, 2013
StatusPublished
Cited by9 cases

This text of 72 A.3d 742 (Blair v. Bureau of Professional & Occupational Affairs) is published on Counsel Stack Legal Research, covering Commonwealth Court of Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Blair v. Bureau of Professional & Occupational Affairs, 72 A.3d 742, 2013 WL 3865102, 2013 Pa. Commw. LEXIS 276 (Pa. Ct. App. 2013).

Opinion

OPINION BY

Judge SIMPSON.

Eric James Blair, R.N., (Licensee) petitions for review of a final order of the State Board of Nursing (Board) that stayed an indefinite suspension of his professional nursing license in favor of probation subject to 42 conditions, including monitoring conditions that restrict Licensee from practicing in a homecare setting for a minimum of three years. Primarily, Licensee contends the Board erred in denying him, as an individual with a disability, a reasonable accommodation to practice in a homecare setting in violation of Title II of the Americans with Disabilities Act of 19901 (ADA) and Section 504 of the Rehabilitation Act of 19732 (Rehab Act). Licensee further asserts he is entitled to an award of attorney fees under those statutes. Upon review, we affirm.

I. Background

A. Generally

Licensee holds a professional nursing license in Pennsylvania, which the Board issued in 2004. In July 2006, the Board suspended Licensee’s license for one year as a result of his conviction for a misdemeanor violation of the Controlled Substance Drug Device and Cosmetic Act (Drug Act).3 Licensee pled nolo contende-re to unlawful possession of Fentanyl, a Schedule II narcotic, and received probation.

Licensee also served 13 months in prison for two counts of felony theft for stripping copper from abandoned coal mines. In June 2007, while incarcerated, Licensee detoxed from heroin.

In September 2008, the Board reinstated Licensee’s unrestricted license following his release from incarceration. In August and September 2008, Licensee submitted to drug screens conducted by Westmoreland County. Licensee’s tests were negative.

However, in October 2008 the Board, pursuant to Section 14(a)(2) of the Profes[746]*746sional Nursing Law (Nursing Law),4 ordered Licensee to submit to a mental and physical examination by Robert M. Wett-stein, M.D. (Board’s Physician), a board certified psychiatrist. Section 14(a)(2) authorizes the Board to suspend or revoke a nursing license if

[t]he licensee is unable to practice professional nursing with reasonable skill and safety to patients by reason of mental or physical illness or condition or physiological or psychological dependence upon alcohol, hallucinogenic, or narcotic drugs or other drugs which tend to impair judgment or coordination, so long as such dependence shall continue.

63 P.S. § 224(a)(2). “In enforcing this clause ... the Board shall, upon probable cause, have the authority to compel a licensee to submit to a mental or physical examination as designated by it.” Id. Licensee submitted to the requested mental and physical examinations in December 2008.

B. Return to Employment

Meanwhile, in November 2008, following a background check and a pre-employment drug screen, an in-home nursing care provider (Current Employer), hired Licensee to provide homecare nursing to a ventilator-dependent quadriplegic patient (Patient), who’s breathing is electronically regulated by a diaphragmatic pacing system (DPS). Patient requires 24-hour nursing care, which is provided by five nurses. Patient’s ultimate goal is to learn to breathe without a ventilator.

In November 2008, Licensee became Patient’s primary care nurse. Working the day shift, Licensee became actively involved in implementing Patient’s DPS. Licensee keeps detailed notes on Patient’s progress, which are evaluated by Patient’s pulmonologists in Pittsburgh and Atlanta, Georgia. Patient is not prescribed any opiate medications.

Patient’s Fiancée oversees Patient’s care by Licensee and other health care professionals. She is aware of Licensee’s substance abuse history and criminal background. However, Patient’s Fiancée saw no indications that Licensee was impaired while working in her home.

C. PNAP

In November 2009, Licensee, on his own, contacted the Pennsylvania Nurse Peer Assistance Program (PNAP). PNAP arranged for Licensee to submit to a chemical dependency evaluation at Gateway Rehabilitation Center (Gateway) in Greensburg, Pennsylvania. In a December 2009 evaluation, Gateway assigned Licensee “an Axis I diagnosis of ‘Opiod Dependence, Sustained Full Remission.’ ” Proposed Adjudication and Order (PAO),5 10/28/10, Finding of Fact (F.F.) No. 30; Reproduced Record (R.R.) at 31a. Gateway recommended Licensee attend 90 group meetings in 90 days with its nurses’ 12-step program. Id. Gateway also recommended that Licensee submit to random urine screens. Id.

Licensee complied with Gateway’s recommendations. Since beginning in December 2009, Licensee consistently tested negative for controlled substances. F.F. No. 31; R.R. at 32a. Also, Licensee’s December 2009 hair follicle test was negative for psychoactive substances. F.F. No. 32; R.R. at 32a.

Nevertheless, PNAP’s standard treatment contract, which is modeled after the Bureau of Professional and Occupational [747]*747Affairs’ (Bureau) Professional Health Monitoring Program (PHMP), prohibits participating nurses from practicing either in a homecare setting or ■without direct supervision in the workplace. As part of its agreement with PHMP, PNAP cannot modify the contract provisions prohibiting practice in an in-home setting. Therefore, Licensee declined to sign a treatment contract. Despite his unwillingness to agree to the prohibition against practicing in a homecare setting, Licensee fully participated in Gateway’s drug screening program and group support treatment.

D. Board Proceeding

Following his examination of Licensee, Board’s Physician submitted a March 2009 report to the Bureau’s prosecuting attorney setting forth Licensee’s medical and substance abuse history.6 Thereafter, the Bureau filed a formal disciplinary action against Licensee alleging he could not practice nursing with reasonable skill and safety to patients in a homecare setting due to his heroin dependence.

In January 2010, the Board held a hearing at which both parties presented evidence. Board’s Physician testified regarding his examinations of Licensee. He assigned Licensee “an Axis I diagnosis of ‘Heroin dependence disorder in reported remission.’ ” F.F. No. 13; R.R. at 29a. He opined Licensee “is safe to practice professional nursing only if he participates in a structured monitoring and treatment program for three to five years for his opiate dependence disorder.” Id. (emphasis added).

Licensee testified on his own behalf. He provided a candid personal history regarding his medical conditions, substance abuse, marriage, family, and employment.

Dr. Alexandre Y. Dombrovski (Licensee’s Physician), a psychiatrist who evaluated Licensee in December 2009, also testified. He assigned Licensee “an Axis I diagnosis of ‘Opiod dependence in full sustained remission.’” F.F. No. 37; R.R. at 33a. He opined Licensee “is safe to practice professional nursing is [sic] he participates in random drug testing.” Id. To that end, Licensee’s Physician agreed with Gateway’s treatment recommendations and indicated “he did ‘not see need for direct supervision.’ ” F.F. No. 38; R.R. at 33a.

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Bluebook (online)
72 A.3d 742, 2013 WL 3865102, 2013 Pa. Commw. LEXIS 276, Counsel Stack Legal Research, https://law.counselstack.com/opinion/blair-v-bureau-of-professional-occupational-affairs-pacommwct-2013.