CMS recommends changes to licensing application questions on mental health, substance use disorder

Wednesday, September 26, 2018 10:16 AM

The Colorado Medical Society recently joined Colorado’s two medical schools, the Colorado Psychiatric Society and others in sending a letter to the Department of Regulatory Agencies (DORA) recommending updates to the mental health and substance use disorder questions on professional licensing applications.

The Colorado medical licensing application includes a question about whether the applicant has been diagnosed with or treated for a condition that may impair his or her ability to practice in a health care field, as well as a question about having “abused or excessively used” alcohol or other habit-forming drugs now or in the past five years.

The organizations stated strong support in the letter of the provision that applicants can answer “No” to both the alcohol/substance use question and the mental illness/neurologic condition question if the condition or behavior is already known to the Colorado Physician Health Program (CPHP).

However, recognizing that not all Colorado health professionals and trainees can establish a relationship with CPHP, the signatories are advocating for changes to the current medical licensure questions so that they focus on current functional impairment: “The screening question about past mental illness diagnoses should be eliminated. General screening inquiries about past psychiatric diagnoses and treatment are overbroad, discriminatory and have little predictive value concerning an applicant’s present ability to function competently and safely in his or her professional role.”

“Our primary concern with a requirement to disclose prior mental health or substance use disorder diagnoses as a condition of state licensure is that it discourages physicians, medical students and resident trainees from seeking needed care. … Physicians with untreated mental health or substance use diagnoses pose a greater risk to the public than those who have sought and received successful treatment.”

The organizations recommend using the following questions to inquire about the applicant’s ability to work safely.

Question: Are you currently using narcotics, drugs or intoxicating liquors to such an extent that your ability to practice [law / medicine / other profession] in a competent, ethical and professional manner would be impaired? (Yes/No)

Question: Are you currently suffering from any condition for which you are not being appropriately treated that impairs your judgment or that would otherwise adversely affect your ability to practice medicine in a competent, ethical and professional manner? (Yes/No)