Justin Rodebaugh 1 SubstanceAbuse PDF

SUPERSEDINGSTEPI
CONSENTAGREEMENT
BETWEEN
JUSTINMATTHEWRODEBAUGH,M.D.
AND
THESTATEMEDICALBOARDOFOHIO
ThisConsentAgreementis entered into byand betweenJustinMatthewRodebaugh,M.D., [Dr.
Rodebaugh], and the StateMedicalBoardofOhio [Board],astateagencychargedwithenforcing
Chapter4731., OhioRevised Code.
Dr.Rodebaughenters into this ConsentAgreementbeingfully informed ofhis rights underChapter
119., Ohio Revised Code, includingthe rightto representation by counseland the rightto aformal
adjudicativehearingon the issuesconsideredherein.
BASISFORACTION
ThisConsentAgreementis entered intoon thebasisofthefollowing stipulations, admissionsand
understandings:
A. TheBoard is empowered bySection4731.22(B),OhioRevisedCode,to limit, revoke,
suspend acertificate,refuseto registerorreinstatean applicant,orreprimandorplaceon
probationthe holderofacertificatefor violationofSection4731.22(B)(26),Ohio
Revised Code,for "impairmentofabilityto practiceaccordingto acceptableand
prevailingstandardsofcarebecauseofhabitual orexcessiveuse orabuseofdrugs,
alcohol,orothersubstancesthat impairabilityto practice;"and/orSection
4731.22(B)(15),OhioRevised Code,"[v]iolationofthe conditionsofIimitationplaced
bythe board uponacertificateto practice."
B. TheBoardenters intothis ConsentAgreement in lieu offormal proceedingsbased upon
theviolationofSection4731.22(B)(15), Ohio Revised Code, as setforth in Paragraph E
below, and based upon the violationofSection4731.22(B)(26), OhioRevisedCode,as
setforth herein. TheBoardexpresslyreserves the rightto instituteformal proceedings
based upon anyotherviolationsofChapter4731. oftheRevised Code,whether
occurringbeforeoraftertheeffectivedateofthis SupersedingStepIConsent
Agreement..
C. Dr. Rodebaugh admits thathis trainingcertificate in theStateofOhio,License
#57.015418,wasrevoked. Therevocationwasstayedand his trainingcertificatewas
indefinitelysuspended,butnot lessthan oneyear,pursuantto thetermsofa Superseding
StepIConsentAgreementBetweenJustinMatthewRodebaugh,M.D.,and the State
SUPERSEDING STEPICONSENTAGREEMENT
JUSTINMATTI-IEWRODEBAUGH,M.D.
PAGE2
MedicalBoardofOhio,effectiveOctober 13,20I0 [October20I0 SupersedingStepI
ConsentAgreement].
D. Dr. Rodebaughstatesthathedoesnotholda trainingcertificate, noris he licensed to
practice medicineorsurgery, in anyotherstateorjurisdiction.
E. Dr. Rodebaughadmitsthathe ispresentlysubjectto a stayedrevocationofhistraining
certificate,an indefinitesuspensionofnot less than oneyear,and monitoringbythe
BoardpursuanttotheOctober20I0 SupersedingStepIConsentAgreement,whichwas
based on Dr. Rodebaugh'saddictionto and secondrelapseonalcohol.
Dr. RodebaughadmitsthattheOctober20I0 SupersedingStepIConsentAgreement
requiresthathe abstaincompletelyfrom theuseofalcohol. Despitethis requirement,
Dr. RodebaughadmitsthatsoonafterbeingdischargedonoraboutDecember 12, 20I0,
from Glenbeigh,a Boardapprovedtreatmentproviderin RockCreek,Ohio,followinga
second relapsein lessthanoneyear,thatheagainbeganto consumealcohol. Dr.
Rodebaughadmitsthathecontinued to consumealcohol until onoraboutDecember17,
20I0, whenhewasadmittedto theClevelandClinicFoundation,a Boardapproved
treatmentproviderinCleveland,Ohio,fordetox. Dr. Rodebaugh admitsthathewas
discharged from detoxonoraboutDecember23,20I0, andonthatsamedayagain
consumedalcohol. HewassubsequentlyarrestedonDecember23,20I0, in WaltonHills
Ohioand charged with Operatinga VehicleUndertheInfluenceofAlcohol orDrugs, in
violation ofSection4511.19,OhioRevisedCode.
Dr. Rodebaughacknowledgesthatthis is his third relapseand thathehasfailed to
maintainsobrietyforat leastoneyearfollowing his discharge from Glenbeighonor
aboutDecember 12, 20IO. Dr. Rodebaughfurtheracknowledgesthatbyadministrative
rulehe is required to repeata minimumoftwenty-eightdaysofinpatienttreatmentata
Boardapproved facility. Dr. RodebaughadmitsthatonoraboutDecember29, 2010,he
entered in-patienttreatmentforhisalcoholaddictionattheClevelandClinicFoundation.
AGREEDCONDITIONS
Wherefore, in considerationoftheforegoingand mutualpromiseshereinaftersetforth, and in lieu
ofanyformal proceedingsatthis time, Dr. Rodebaughknowinglyandvoluntarilyagreeswiththe
Boardto thefollowingterms,conditionsand limitations:
REVOCATIONSTAYED; SUSPENSIONOFCERTIFICATE
1. ThetrainingcertificateofDr.Rodebaugh in the StateofOhio shall beREVOKED.
Suchrevocation is STAYEO,and Dr. Rodebaugh'strainingcertificateshall be
SUSPENDEDforan indefiniteperiodoftime, butnotlessthanthreeyearsfrom the
effectivedateofthissubsequentSupersedingStepIConsentAgreement. Duringsuch
suspension,Dr. Rodebaughshall be ineligibleto receiveorholdanyothercertificate
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SUPERSEDINGSTEPICONSENTAGREEMENT
PAGE3
issued by the Board. TheprevioussuspensionofDr. Rodebaugh's trainingcertificate in
the StateofOhioforan indefiniteperiodoftimebutnotlessthan oneyear, stemming
from the October2010SupersedingStepIConsentAgreement, is herebyterminated
upon theeffectivedateofthis instantSupersedingStepIConsentAgreement.
Obeyall Laws
2. Dr. Rodebaughshallobeyall federal, state,and local laws.
Sobriety
3. Dr. Rodebaughshallabstain completelyfrom thepersonaluseorpersonalpossessionof
drugs, exceptthoseprescribed,dispensedoradministered to him byanotherso
authorized by lawwho hasfull knowledgeofDr. Rodebaugh'shistoryofchemical
dependency. Further, in theeventthatDr.Rodebaugh is so prescribed,dispensedor
administeredanycontrolledsubstance,carisoprodol, ortramadol, Dr. Rodebaughshall
notifythe Board in writingwithinsevendays, providingtheBoardwiththe identityof
theprescriber; thenameofthe drug Dr. Rodebaughreceived; the medical purposefor
whichhe receivedsaiddrug;thedate suchdrugwas initiallyreceived; and thedosage,
amount, numberofrefills, anddirectionsfor use. Further,within thirtydaysofthedate
said drug is so prescribed, dispensed, oradministeredto him, Dr. Rodebaughshall
providethe Boardwitheitheracopyofthewrittenprescriptionorotherwritten
verification from theprescriber, includingthedosage,amount, numberofrefills, and
directionsforuse.
4. Dr. Rodebaughshall abstaincompletelyfrom the useofalcohol.
Absencesfrom Ohio
5. Dr. Rodebaughshall obtainpermissionfrom the Board for departuresorabsencesfrom
Ohio. Suchperiodsofabsenceshall not reduce the probationaryterm, unlessotherwise
determinedbymotionofthe Boardforabsencesofthree monthsorlonger,orbythe
Secretaryorthe SupervisingMemberoftheBoard for absencesofless than three
months, in instanceswheretheBoard can be assuredthatprobationarymonitoringis
otherwise beingperformed. Further,theSecretaryand SupervisingMemberoftheBoard
shall havethediscretionto grantawaiverofpartorall ofthe monitoringtermssetforth
in this ConsentAgreementforoccasionalperiodsofabsenceoffourteen daysorless. In
theeventthatDr.Rodebaughresidesand/oris employed ata location thatis withinfifty
milesofthegeographic borderofOhioand anyofits contiguousstates,Dr. Rodebaugh
maytravel betweenOhio andthatcontiguousstatewithoutseekingpriorapprovalofthe
SecretaryorSupervisingMemberprovidedthatDr. Rodebaugh is ableto otherwise
maintain full compliancewithall otherterms, conditionsand limitationssetforth in this
ConsentAgreement.
MAR 08 20ft
JUSTINMATTl-IEW RODEBAUGH, M.D.
PAGE4
Releases; QuarterlyDeclarationsand Appearances
6. Dr.Rodebaugh shallprovideauthorization,throughappropriatewrittenconsentforms,
fordisclosureofevaluativereports, summaries, and records,ofwhatevernature, byany
andall partiesthatprovidetreatmentorevaluationfor Dr. Rodebaugh'schemical
dependencyorrelated conditions, orforpurposesofcomplyingwiththis Consent
Agreement,whethersuchtreatmentorevaluationoccurredbeforeoraftertheeffective
dateofthis ConsentAgreement. Totheextentpermitted bylaw, theabove-mentioned
evaluativereports, summaries,andrecordsareconsidered medical recordsforpurposes
ofSection 149.43 oftheOhioRevisedCodeandareconfidentialpursuantto statute. Dr.
Rodebaughfurtheragrees to providetheBoardwrittenconsentpermittinganytreatment
providerfrom whomheobtainstreatmentto notifythe Board in theeventhe fails to
agreeto orcomplywith anytreatmentcontractoraftercarecontract. Failureto provide
such consent,orrevocationofsuchconsent,shaH constituteaviolationofthis Consent
Agreement.
7. Dr. Rodebaugh shall submitquarterlydeclarations underpenaltyofBoard disciplinary
actionand/orcriminalprosecution,statingwhetherthere has beencompliancewithaH
theconditionsofthisConsentAgreement. Thefirstquarterlydeclarationmust be
received in the Board'sofficesonthefirstdayofthethird monthfoHowing themonth in
whichthis ConsentAgreementbecomeseffective,orasotheIWise requested bythe
Board. Subsequentquarterlydeclarationsmustbe received in theBoard'sofficesonor
beforethefirstdayofeverythird month.
8. Dr. Rodebaughshallappearin personforan interviewbeforethefull Board orits
designated representativeduringthethirdmonthfollowingthe effectivedateofthis
ConsentAgreement. Subsequentpersonal appearancesmustoccureverythree months
thereafter, and/oras otheIWiserequested bytheBoard. Ifanappearanceis missedoris
rescheduled foranyreason,ensuingappearancesshaH bescheduledbasedonthe
appearancedateas originallyscheduled.
Drug& Alcohol Screens;DrugTestingFacilityand CollectionSite
9. Dr. RodebaughshaH submittorandom urinescreeningsfordrugsand alcohol at least
fourtimespermonth, oras otheIWisedirected bytheBoard. Dr. RodebaughshaH ensure
thatall screeningreportsarefOIWarded directlyto the Boardonaquarterly basis. The
drugtestingpanel utilizedmustbe acceptableto theSecretaryoftheBoard, and shall
includeDr. Rodebaugh'sdrug(s)ofchoice.
Dr. Rodebaugh shall abstainfrom the use ofanysubstanceand theconsumptionof
poppyseedsoranyotherfood orliquidthatmayproducea low level positiveresult in a
toxicologyscreen. Dr.Rodebaughacknowledgesthathe understandsthatthe
MA) 0 2011
SUPERSEDING STEP I CONSENT AGREEMENT
JUSTIN MATTHEW RODEBAUGH, M.D.
PAGES
consumption or use of such substances, including but not limited to substances such as
mouthwash or hand cleaning gel, may cause a positive drug screen that may not be able
to be differentiated from intentional ingestion, and therefore such consumption or use is
prohibited under this Consent Agreement.
All such urine screenings for drugs and alcohol shall be conducted through a Board-
approved drug testing facility and coIlection site pursuant to the global contract between
said facility and the Board, that provides for the Board to maintain ultimate control over
the urine screening process and to preserve the confidentiality of all positive screening
results in accordance with Section 4731.22(F)(5), Ohio Revised Code, and the screening
process shall require a daily caIl-in procedure. Further, in the event that the Board
exercises its discretion, as provided in Paragraph 10 below, to approve urine screenings
to be conducted at an alternative drug testing facility and/or collection site or a
supervising physician, such approval shall be expressly contingent upon the Board
retaining ultimate control over the urine screening process in a manner that preserves the
aforementioned confidentiality of all positive screening results.
Dr. Rodebaugh shall submit, at his expense and on the day selected, urine specimens for
drug and/or alcohol analysis. All specimens submitted by Dr. Rodebaugh shaIl be
negative, except for those substances prescribed, administered, or dispensed to him in
conformance with the terms, conditions and limitations set forth in this Consent
Agreement. Refusal to submit such specimen, or failure to submit such specimen on the
day he is selected or in such manner as the Board may request, shall constitute a
violation of this Consent Agreement.
Further, within thirty days of the effective date of this Consent Agreement, Dr.
Rodebaugh shall enter into the necessary financial and/or contractual arrangements with
the Board-approved drug testing facility and/or collection site in order to facilitate the
urine screening process in the manner required by this Consent Agreement. Further, Dr.
Rodebaugh shall promptly provide to the Board written documentation of completion of
such arrangements, including a copy of any contract entered into between Dr. Rodebaugh
and the Board-approved drug testing facility and/or collection site. Dr. Rodebaugh's
failure to timely complete such arrangements, or failure to timely provide written
documentation to the Board of completion of such arrangements, shall constitute a
Dr. Rodebaugh shall ensure that the urine screening process performed through the
Board-approved drug testing facility and/or collection site requires a daily caIl-in
procedure; that the urine specimens are obtained on a random basis; and that the giving
of the specimen is witnessed by a reliable person. In addition, Dr. Rodebaugh and the
Board-approved drug testing facility and collection site shall assure that appropriate
control over the specimen is maintained and shall immediately inform the Board of any
positive screening results.
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JUSTINMATTHEWRODEBAUGH, M.D.
PAGE6
Dr. RodebaughshallensurethattheBoard-approveddrugtestingfacilityand/or
collectionsite providesquarterlyreportsto theBoard,in aformatacceptableto the
Board,verifyingwhetherall urinescreenshavebeenconductedin compliancewith this
ConsentAgreement,andwhetherall urinescreenshavebeennegative.
In theeventthatthe Board-approveddrugtestingfacilityand/orcollectionsite becomes
unableorunwillingto serveas required bythis ConsentAgreement,Dr. Rodebaugh
mustimmediatelynotifytheBoard in writing,andmakearrangementsacceptableto the
Board,pursuantto Paragraph 10 below,as soonaspracticable. Dr. Rodebaughshall
furtherensurethattheBoard-approveddrugtestingfacilityand/orcollectionsitealso
notifies the Boarddirectlyofits inabilityto continueto serveand the reasons therefore.
Dr. RodebaughacknowledgesthattheBoard expresslyreserves the rightto withdrawits
approvalofanydrugtestingfacilityand/orcollectionsite in theeventthatthe Secretary
and SupervisingMemberoftheBoarddeterminethatthedrugtestingfacilityand/or
collectionsitehasdemonstrateda lackofcooperation in providinginformation to the
Boardorfor anyotherreason.
10. Dr. Rodebaugh and theBoardagreethatit is the intentofthis ConsentAgreementthat
Dr. Rodebaughshallsubmithis urinespecimens to the Board-approveddrugtesting
facilityand collectionsitechosen bytheBoard. However, in theeventthatutilizingsaid
Board-approveddrugtestingfacilityand/orcollectionsitecreatesan extraordinary
hardship uponDr. Rodebaugh,as determined in thesolediscretionoftheBoard,then
subjectto thefollowing requirements,the Boardmayapprovean alternatedrugtesting
facilityand/orcollectionsite, orasupervisingphysician,to facilitate theurinescreening
processforDr.Rodebaugh:
a. Withinthirtydaysofthe dateuponwhichDr. Rodebaugh is notified ofthe Board's
determinationthatutilizingtheBoard-approveddrugtestingfacilityand/or
collectionsiteconstitutesanextraordinaryhardship uponDr. Rodebaugh,heshall
submitto theBoard in writingfor itspriorapproval the identityofeitheran
alternatedrugtestingfacilityandcollectionsite,orthe nameofaproposed
supervisingphysician, to whomDr. Rodebaughshallsubmittherequired urine
specimens. In approvingafacility, entity,oran individual to serve in thiscapacity,
the Boardwill givepreferencetoa facilitylocatednearDr.Rodebaugh'sresidence
oremploymentlocation,ortoaphysicianwhopractices in thesame localeasDr.
Rodebaugh. Dr. Rodebaughshallensurethatthe urinescreeningprocess
performed throughthealternatedrugtestingfacilityand/orcollectionsite,or
through thesupervisingphysician,requiresadailycall-inprocedure;thattheurine
specimensareobtainedona random basis;and thatthegivingofthespecimenis
witnessedbya reliableperson. Inaddition,Dr. Rodebaughacknowledgesthatthe
alternatedrugtestingfacilityand collectionsite,orthe supervisingphysician, shall
assure thatappropriatecontroloverthespecimen is maintainedandshall
immediatelyinformthe Boardofanypositivescreeningresults.
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JUSTIN MATTHEWRODEBAUGH, M.D.
PAGE7
b. Dr. Rodebaughshall ensurethatthealternatedrugtestingfacility and/orcollection
site, orthesupervisingphysician,providesquarterlyreportstotheBoard, in a
formatacceptableto theBoard,verifyingwhetherall urinescreenshave been
conducted in compliancewiththis ConsentAgreement,and whetherall urine
screenshave been negative.
c. Intheeventthatthedesignated alternatedrugtestingfacilityand/orcollectionsite,
orthesupervisingphysician, becomesunableorunwillingto soserve,Dr.
RodebaughmustimmediatelynotifytheBoard in writing. Dr. Rodebaughshall
furtherensurethatthepreviouslydesignated alternatedrugtestingfacilityand
collectionsite,orthesupervisingphysician,also notifiestheBoarddirectlyofthe
inabilityto continueto serveandthereasonstherefore. Further, in orderto ensure
thattherewillbeno interruption in his urinescreeningprocess, uponthe previously
approved alternatedrugtestingfacility, collectionsite,orsupervisingphysician
becomingunableto serve,Dr. Rodebaughshall immediatelycommenceurine
screeningattheBoard-approveddrugtestingfacilityand collectionsitechosenby
theBoard, untilsuchtime, ifany,thattheBoardapprovesasubsequentalternate
drugtestingfacility, collectionsite,orsupervisingphysician, ifrequested byDr.
Rodebaugh.
d. TheBoardexpresslyreservestherightto disapproveanyentityorfacilityproposed
to serveas Dr. Rodebaugh'sdesignated alternatedrugtestingfacilityand/or
collectionsite, oranypersonproposedto serveas his supervisingphysician,orto
withdrawapprovalofanyentity,facilityorpersonpreviouslyapproved to soserve
in theeventthattheSecretaryand SupervisingMemberofthe Boarddeterminethat
anysuchentity,facilityorperson has demonstrated a lackofcooperation in
providing informationto theBoard orfor anyotherreason.
11. All screeningreportsrequired underthis ConsentAgreementfrom the Board-approved
drugtestingfacilityand/orcollectionsite,orfrom thealternatedrugtestingfacility
and/orcollectionsiteorsupervisingphysician, mustbereceived in theBoard'soffices
no laterthantheduedatefor Dr. Rodebaugh'squarterlydeclaration. It is Dr.
Rodebaugh'sresponsibilityto ensurethatreportsaretimelysubmitted.
12. TheBoard retainstherightto require,andDr. Rodebaughagreesto submit,blood, urine,
breath,salivaand/orhairspecimensforscreeningfordrugsand alcohol, for analysis of
therapeutic levelsofmedicationsthatmaybeprescribed for Dr. Rodebaugh,orfor any
otherpurpose,atDr. Rodebaugh'sexpenseupontheBoard'srequestandwithoutprior
notice. Dr. Rodebaugh's refusalto submitaspecimenupon requestofthe Boardshall
resultin a minimumofoneyearofactual licensesuspension. Further,thecollectionof
such specimensshall bewitnessed byarepresentativeoftheBoard,oranotherperson
acceptableto theSecretaryorSupervisingMemberofthe Board.
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JUSTINMATHiEWRODEBAUGH, M.D.
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RehabilitationProgram
13. Withinthirtydaysoftheeffectivedateofthis ConsentAgreement, Dr. Rodebaughshall
undertakeandmaintainparticipation in an alcohol and drugrehabilitationprogram,such
as A.A.,N.A.,C.A.,orCaduceus,no lessthan threetimesperweek. Substitutionof any
otherspecificprogrammustreceivepriorBoardapproval.
Dr. Rodebaughshall submitacceptabledocumentaryevidenceofcontinuingcompliance
with thisprogram, includingsubmissionto the Boardofmeetingattendance logs, which
mustbereceived in theBoard'sofficesno laterthanthe due date for Dr. Rodebaugh's
quarterlydeclarations.
14. Immediatelyuponcompletionofanyrequired treatmentforchemicaldependency,Dr.
Rodebaughshall enterinto anaftercarecontractwith aBoard-approved treatment
providerand shallmaintaincontinuedcompliancewiththe termsofsaidaftercare
contract,provided that, wherethetermsoftheaftercarecontractconflictwiththeterms
ofthis ConsentAgreement,thetermsofthis ConsentAgreementshaH control.
CONDITIONS FOR REINSTATEMENT
15. TheBoardshall notconsiderreinstatementorrestorationofDr. Rodebaugh'straining
certificateorissuanceofanyothercertificateto Dr. Rodebaughuntil all ofthefollowing
conditionsaremet:
a. Dr. Rodebaughshall submitanapplicationfor reinstatementorrestorationofhis
trainingcertificateoran applicationforanyothercertificate,asappropriate,
accompanied by appropriatefees, ifany.
b. Dr.Rodebaughshalldemonstrateto the satisfactionoftheBoard thathecan
resumepracticein compliancewith acceptableand prevailingstandardsofcare
underthe provisionsofhis certificate. Suchdemonstrationshall includebutshall
notbe limited tothefoHowing:
J. Certificationfrom atreatmentproviderapproved underSection4731.25 of
the RevisedCodethatDr.Rodebaughhassuccessfullycompletedany
required inpatienttreatment, includingat leasttwenty-eightdaysofinpatient
orresidentialtreatmentforchemical abuse/dependence,as setforth in Rules
4731-16-02and 4731-16-08,OhioAdministrativeCode,completed
consecutively.
11. Evidenceofcontinuingfull compliancewith,orsuccessfulcompletionof, a
post-dischargeaftercarecontractwithatreatmentproviderapproved under
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Section4731.25 ofthe Revised Code. Suchevidenceshall include, butnot
be limited to, acopyofthe signed aftercarecontract. Theaftercarecontract
mustcomplywithrule4731-16-10oftheAdministrativeCode.
iii. Evidenceofcontinuingfull compliancewiththis ConsentAgreement.
IV. Twowrittenreports indicatingthatDr. Rodebaugh'sabilityto practicehas
been assessedandthathe has been found capableofpracticingaccordingto
acceptableand prevailingstandardsofcare. Thereports shall be made by
physiciansknowledgeablein theareaofaddictionologyandwho are either
affiliatedwithacurrentBoard-approvedtreatmentproviderorotherwisehave
beenapproved in advanceby the Boardto providean assessmentofDr.
Rodebaugh. Further,thetwo aforementionedphysiciansshall notbe
affiliatedwiththesametreatmentproviderormedical grouppractice. Prior
to theassessments, Dr. Rodebaughshall providethe evaluatorswithcopiesof
patientrecords from anyevaluations and/ortreatmentthathehasreceived,
andacopyofthis ConsentAgreement. Thereportsfrom the evaluatorsshall
includeanyrecommendationsfor treatment,monitoring, orsupervisionofDr.
Rodebaugh, and anyconditions,restrictions,orlimitationsthatshouldbe
imposedon Dr. Rodebaugh'spractice. Thereports shall also describethe
basisfor theevaluator'sdeterminations.
All reportsrequiredpursuantto thisparagraphshall bebasedupon
examinationsoccurringwithinthethree months immediatelyprecedingany
applicationfor reinstatement. Further,atthediscretionofthe Secretaryand
SupervisingMemberoftheBoard,theBoardmayrequestan updated
assessmentandreportiftheSecretaryand SupervisingMemberdetermine
thatsuchupdatedassessmentandreportis warrantedforanyreason.
v. In theeventthattheBoard initiatesfuture formal proceedingsagainstDr.
Rodebaugh, includingbutnotlimitedto issuanceof aNoticeofOpportunity
for Hearing, Dr. Rodebaughshall be ineligibleforreinstatementorrestoration
ofhis trainingcertificate,orissuanceofanyothercertificate,until such
proceedingsarefullyresolved byratification by theBoardofasubsequent
ConsentAgreementorissuancebytheBoardofafinal Board Order.
c. Dr. Rodebaugh shallenterinto awrittenconsentagreementincludingprobationary
terms, conditionsand limitationsasdeterminedbytheBoardwithin 180daysof
thedateupon which all theabove-specified conditionsfor reinstatementor
restoration ofhis trainingcertificateoran application forothercertificate, as
appropriate, have beencompleted or, iftheBoardand Dr. Rodebaugh are unableto
agreeon thetermsofawrittenConsentAgreement,then Dr. Rodebaughfurther
agrees to abidebyanyterms, conditions and limitations imposed by BoardOrder
afterahearingconductedpursuantto Chapter 119. ofthe Ohio Revised Code. The
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SUPERSEDINGSTEP ICONSENTAGREEMENT
PAGE 10
Boardshallprovidenotice to Dr. Rodebaughthatsaid hearinghas beenscheduled,
advisingDr.Rodebaughofhis hearingrights, and statingthe date, time,and
locationofthehearingatwhichtheBoardwill presentits evidence, afterwhich the
Boardwill makeadeterminationofthematterby BoardOrder.
Further, uponreinstatementofDr. Rodebaugh'strainingcertificateinthis state,or
issuanceofanyothercertificateto Dr. Rodebaugh,the Boardshall require
continuedmonitoringwhichshall include, butnotbe limitedto, compliancewith
the writtenconsentagreemententeredinto beforereinstatement,restoration, or
issuance,orwithconditions imposedbyBoardOrderafterahearingconducted
pursuantto Chapter 119.oftheRevised Code. Moreover,uponterminationofthe
consentagreementorBoard Order, Dr. Rodebaughshall submitto the Boardforat
leasttwoyearsannualprogressreports madeunderpenaltyofBoarddisciplinary
actionorcriminalprosecutionstatingwhetherDr. Rodebaugh has maintained
sobriety.
16. In theeventthatDr. Rodebaughhas notbeenengaged in theactivetrainingand/or
practiceofmedicineand surgeryforaperiod in excessoftwoyearspriorto application
forreinstatement,orrestorationofhis trainingcertificateorapplicationforanyother
certificate,the Board mayexercise its discretionunderSection4731.222,OhioRevised
Code,torequireadditionalevidenceofDr. Rodebaugh'sfitness to resumepractice.
REQUIRED REPORTING BY LICENSEE
17. Withinthirtydays oftheeffectivedateofthis ConsentAgreement, Dr. Rodebaughshall
provideacopyofthis ConsentAgreementto all employersorentitieswith whichhe is
undercontractto providehealth careservices(includingbutnotlimited to third party
payors)oris receivingtraining; andtheChiefofStaffateachhospital wherehe has
privilegesorappointments.Further,Dr.Rodebaugh shallpromptlyprovideacopyofthis
ConsentAgreementto all employersorentitieswithwhichhecontractsto providehealth
careservices, orappliesfororreceivestraining,and the ChiefofStaffateach hospital
wherehe appliesfororobtainsprivilegesorappointments. In theeventthatDr.
Rodebaughprovidesanyhealthcareservicesorhealthcaredirectionormedical
oversightto anyemergencymedical servicesorganizationoremergencymedical services
provider,withinthirtydaysoftheeffectivedateofthis ConsentAgreementDr.
RodebaughshallprovideacopyofthisConsentAgreementto the OhioDepartmentof
PublicSafety,DivisionofEmergencyMedical Services. Further,Dr. Rodebaughshall
providetheBoardwith oneofthe followingdocumentsas proofofeachrequired
notificationwithin thirtydays ofthedateofeachsuch notification: (1) the returnreceipt
ofcertified mail withinthirtydays ofreceivingthatreturnreceipt, (2) an
acknowledgementofdeliverybearingtheoriginal inksignatureofthepersonto whoma
copyofthe ConsentAgreementwashand delivered,(3) theoriginal facsimile-generated
reportconfirmingsuccessfultransmission ofacopyoftheConsentAgreementto the
personorentityto whomacopyofthe ConsentAgreementwasfaxed, or(4) an original
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JUSTINMATTlffiWRODEBAUGH,M.D.
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computer-generatedprintoutofelectronicmail communicationdocumentingtheemail
transmissionofacopyofthe ConsentAgreementto thepersonorentityto whomacopy
ofthe ConsentAgreementwasemailed.
18. Withinthirtydaysoftheeffectivedate ofthis ConsentAgreement, Dr. Rodebaughshall
provideacopyofthis ConsentAgreementto theproper licensingauthorityofanystate
orjurisdictionin which he currentlyholdsanyprofessional license,as well asanyfederal
agencyorentity, includingbutnotlimitedto the DrugEnforcementAgency, through
whichhecurrentlyholdsanylicenseorcertificate. Dr. Rodebaughfurtheragreesto
provideacopyofthis ConsentAgreementattimeof application to theproperlicensing
authorityofanystate in whichheappliesfor anyprofessional licenseorreinstatementof
anyprofessional license. Further,Dr. RodebaughshallprovidetheBoardwithoneofthe
followingdocumentsasproofofeach required notificationwithinthirtydaysof thedate
ofeachsuchnotification: (l)thereturn receiptofcertified mail withinthirtydays of
receivingthatreturnreceipt, (2) anacknowledgementofdeliverybearingthe original ink
signatureofthe personto whom acopyof theConsentAgreementwashand delivered,
(3) theoriginalfacsimile-generated reportconfirmingsuccessful transmissionof acopy
ofthe ConsentAgreementto thepersonorentityto whom acopyoftheConsent
Agreementwasfaxed, or(4)an originalcomputer-generated printoutofelectronicmail
communicationdocumentingtheemailtransmissionofacopyofthe ConsentAgreement
to the personorentityto whomacopyoftheConsentAgreementwasemailed.
19. Dr. Rodebaugh shall promptlyprovideacopyofthis ConsentAgreementto all persons
and entitiesthatprovideDr. Rodebaughchemicaldependencytreatmentormonitoring.
Further,Dr. Rodebaugh shallprovidetheBoardwith oneofthe following documentsas
proofofeach required notificationwithinthirtydaysofthe dateof eachsuch
notification: (l)the return receiptofcertified mail withinthirtydays ofreceivingthat
return receipt, (2)an acknowledgementofdeliverybearingthe original ink signatureof
thepersonto whom a copyoftheConsentAgreementwashanddelivered,(3)the
original facsimile-generated reportconfirmingsuccessfultransmissionofacopyofthe
ConsentAgreementto thepersonorentityto whomacopyofthe ConsentAgreement
wasfaxed, or(4)anoriginalcomputer-generated printoutofelectronic mail
communicationdocumentingtheemailtransmissionofacopyofthe ConsentAgreement
to the personorentityto whomacopyofthe ConsentAgreementwasemailed.
20. Dr. RodebaughshallnotifytheBoardin writingofanychangeofprincipal practice
addressorresidenceaddress withinthirtydays ofsuchchange.
DURATIONIMODIFICATION OF TERMS
Theabove-describedterms,conditionsand limitationsmaybeamendedorterminatedin writingat
anytimeupon the agreementofbothparties. In theeventthattheBoard initiatesfuture fonnal
I R 201
PAGE 12
proceedings against Dr. Rodebaugh, including but not limited to issuance of a Notice of Opportunity
for Hearing, this Consent Agreement shall continue in full force and effect until such time that it is
superseded by ratification by the Board of a subsequent Consent Agreement or issuance by the
Board of a final Board Order.
In the event that any term, limitation, or condition contained in this Consent Agreement is
determined to be invalid by a court of competent jurisdiction, Dr. Rodebaugh and the Board agree
that all other terms, limitations, and conditions contained in this Consent Agreement shall be
unaffected.
FAILURE TO COMPLY
If, in the discretion of the Secretary and Supervising Member of the Board, Dr. Rodebaugh appears
to have violated or breached any term or condition of this Consent Agreement, the Board reserves
the right to institute formal disciplinary proceedings for any and all possible violations or breaches,
including but not limited to, alleged violations of the laws of Ohio occurring before the effective
date of this Consent Agreement.
ACKNOWLEDGMENTSILIABILITY RELEASE
Dr. Rodebaugh acknowledges that he has had an opportunity to ask questions concerning the terms
of this Consent Agreement and that all questions asked have been answered in a satisfactory
manner.
Any action initiated by the Board based on alleged violations of this Consent Agreement shall
comply with the Administrative Procedure Act, Chapter 119., Ohio Revised Code.
Dr. Rodebaugh hereby releases the Board, its members, employees, agents, officers and
representatives jointly and severally from any and all liability arising from the within matter.
This Consent Agreement shall be considered a public record as that term is used in Section 149.43,
Ohio Revised Code. Further, this information may be repOited to appropriate organizations, data
banks and governmental bodies. Dr. Rodebaugh acknowledges that his social security number will
be used if this information is so reported and agrees to provide his social security number to the
Board for such purposes.
EFFECTIVE DATE
It is expressly understood that this Consent Agreement is subject to ratification by the Board prior to
signature by the Secretary and Supervising Member and shall become effective upon the last date of
MAf?OR 2lJU
SUPERSEDINGSTEPICONSENTAGREEiv1ENT
PAGE 13
signaturebelow. Further, theaforementionedOctober2010SupersedingStepIConsentAgreement
shall beterminated uponthis subsequentSupersedingStepIConsentAgreementbecoming
effective.
-
~
TINMATTHEWRODEBAUGH,M.D. LANCEA. TALMAGE,M.D.
Secretary
DATE DATE
r ~
~ ~
Attorneyfor Dr. Rodebaugh
3-7-//
DATE DATE
SHELDONSAF a
EnforcementAttorney
3 S-
DATE
MAR 0 2Dl1
SUPERSEDINGSTEPI
CONSENTAGREEMENT
BETWEEN
AND
THE STATEMEDICALBOARDOF OHIO
This ConsentAgreement isentered into byand between Justin Matthew Rodebaugh, M.D. ,[Dr.
Rodebaugh],and the State Medical Board ofOhio [Board],astate agency charged with enforcing
Chapter4731., Ohio Revised Code.
Dr. Rodebaughenters intothis ConsentAgreement being fully informed ofhis rights under Chapter
119.,Ohio Revised Code, includingthe right torepresentation bycounsel and the right toa formal
adjudicative hearing on the issuesconsidered herein.
BASISFOR ACTION
This ConsentAgreement isentered intoon the basis ofthe following stipulations,admissionsand
understandings:
A. The Board isempowered bySection 4731.22(B), Ohio Revised Code, to limit, revoke,
suspendacertificate,refuse toregisteror reinstateanapplicant,or reprimandor place on
probation the holder ofacertificatefor violation ofSection 4731.22(B)(26),Ohio
Revised Code, for "impairmentof ability to practiceaccordingtoacceptableand
prevaiIingstandardsofcare because ofhabitual orexcessiveuseorabuse ofdrugs,
alcohol,orothersubstancesthat impair ability topractice;" and/or Section
4731.22(B)(15),Ohio Revised Code, "[v]iolation ofthe conditionsofIimitation placed
bythe board upon acertificateto practice."
B. TheBoard enters intothis ConsentAgreementin lieuofformal proceedings based upon
the violation ofSection 4731.22(B)(IS), Ohio Revised Code,as set forth in Paragraph E
below, and based upon the violation ofSection 4731.22(B)(26),Ohio Revised Code, as
set forth herein. The Board expressly reserves the right to institute formal proceedings
based upon any otherviolationsofChapter4731. ofthe Revised Code, whether
occurring before orafter theeffectivedate ofthis SupersedingStep I Consent
Agreement.
c. Dr. Rodebaugh admitsthat histraining certificate inthe State ofOhio,License
#57.0154I8,was indefinitelysuspended, but not lessthan 90days, pursuant tothe terms
of aStep 1ConsentAgreement Between Justin Matthew Rodebaugh, M.D., and the State
Medical Board ofOhio,effectiveSeptember9,2010 [September2010Step IConsent
Agreement], acopy ofwhich isattached hereto and incorporated herein.
MED\CAL BOARD
CT 0 2010
SUPERSEDINGSTEP1CONSENTAGREEMENT
JUSTINMATTHEWROEBAUGH,M.D.
PAGE2
D. Dr. Rodebaugh states that hedoes notholdatraining certificate, norishelicensed to
practice medicine orsurgery, inanyother state orjurisdiction.
E. Dr. Rodebaugh admits that he ispresently subject toalicense suspension and monitoring
bythe Board pursuant tothe September20IStep IConsent Agreementwhich was
basedon Dr. Rodebaugh'saddiction toand relapse onalcohol. Dr.Rodebaugh further
admits thatafter beingdischarged from inpatient treatment on September2,20I0,
treatment complete, heexecuted theaforementioned September2010 Step IConsent
Agreementon September3,20 I0.
Dr.Rodebaugh admits thattheSeptember20IStep IConsentAgreementrequires that
heabstain completelyfromtheuseofalcohol. Despite this requirement, Dr.Rodebaugh
admits thaton September9,20I0,heconsumed alcohol andwassubsequentlyarrested in
Solon, Ohio,andcharged withOperatinga Vehicle Underthe Influenceof Alcohol or
Drugs, inviolation ofSection 4511.19, Ohio Revised Code. Dr.Rodebaugh
acknowledgesthathisconsumption ofalcohol onSeptember9,20I0,constituteshis
second relapse inlessthanone year. Dr.Rodebaugh admits thatonorabout September
10,2010,heentered in-patient treatment forhisalcohol addiction and second relapse at
Glenbeigh,a Boardapproved treatment provider inRockCreek, Ohio. Further, Dr.
Rodebaugh acknowledgesthat because hefailed tomaintainsobriety forat leastone year
following hisdischarge from inpatient treatment on September2,20I0, by
administrative rulehe isrequired torepeata minimum oftwenty-eightdaysofinpatient
treatment ata Board-approved treatment facility.
AGREED CONDITIONS
Wherefore, inconsiderationoftheforegoing and mutual promises hereinaftersetforth, and inlieu
ofany formal proceedings atthistime, Dr.Rodebaugh knowingly and voluntarily agrees with the
Board tothe following terms,conditionsand limitations:
REVOCATION, STAYED; SUSPENSION OF CERTIFICATE
I. The training certificate ofDr.Rodebaugh intheStateofOhio shall beREVOKED.
Such revocation isSTAYEO, and Dr.Rodebaugh'straining certificateshall be
SUSPENDEDforan indefinite periodoftime, butnot lessthanone yearfrom the
effective date ofthisSupersedingStep r Consent Agreement. During such suspension,
Dr. Rodebaugh shall beineligible toreceiveorholdanyother certificate issued bythe
Board. The previous suspension ofDr.Rodebaugh'straining certificate intheStateof
Ohio foran indefinite periodof time,butnot lessthan90days, stemming fromthe
September20IStep]ConsentAgreement, ishereby terminated upontheeffective date
ofthe instant SupersedingStep IConsent Agreement.
Obeyall Laws
ME ICAl BOARD
OCT06 2010
PAGE3
2. Dr.Rodebaugh shallobeyall federal,state,and locallaws.
Sobriety
3. Dr.Rodebaugh shallabstain completely fromthe personal useor personal possession of
drugs,except those prescribed,dispensed oradministered tohim byanother so
authorized byJawwho hasfull knowledge ofDr.Rodebaugh's historyofchemical
dependency. Further, intheevent thatDr.Rodebaugh isso prescribed, dispensed or
administered anycontrolled substance, carisoprodol, ortramadol, Dr.Rodebaugh shall
notifytheBoardinwritingwithinsevendays, providing theBoardwiththeidentityof
the prescriber;the nameofthedrug Dr.Rodebaugh received; themedical purposefor
which hereceived saiddrug;thedatesuchdrugwas initiallyreceived; and thedosage,
amount, number ofrefills,anddirections foruse. Further, withinthirtydaysofthedate
saiddrug isso prescribed,dispensed,oradministered tohim,Dr.Rodebaugh shall
providetheBoardwitheither acopyofthewritten prescription orother written
verification fromthe prescriber,includingthedosage, amount, numberof refills,and
directions foruse.
4. Dr.Rodebaugh shallabstaincompletely fromtheuseofalcohol.
Absences fromOhio
5. Dr.Rodebaugh shallobtain permission fromtheBoardfordepartures orabsences from
Ohio. Such periodsofabsenceshall notreducethe probationary term,unlessotherwise
determined bymotionoftheBoard forabsences ofthree monthsorlonger,or bythe
Secretary ortheSupervising Member ofthe Boardforabsences oflessthanthree
months,ininstances wherethe Boardcan beassured that probationary monitoring is
otherwise being performed. Further,theSecretary andSupervising Memberofthe
Boardshall havethediscretion tograntawaiverofpartorallofthemonitoring terms
setforth inthisConsent Agreement foroccasional periodsofabsence offourteendays or
less. Intheevent that Dr.Rodebaugh residesand/or isemployed atalocationthat is
within fiftymilesofthegeographic borderofOhioandanyofitscontiguous states, Dr.
Rodebaugh maytravel betweenOhioandthatcontiguous state withoutseeking prior
approval oftheSecretary orSupervising Member providedthat Dr.Rodebaugh isable to
otherwise maintain fullcompliance withallother terms,conditions and limitationsset
forth inthisConsent Agreement.
Releases; Quarterly Declarations andAppearances
6. Dr.Rodebaugh shall provideauthorization, through appropriate writtenconsent forms,
for disclosure of evaluative reports, summaries, and records,of whatever nature, by any
andall partiesthat providetreatment orevaluation forDr.Rodebaugh'schemical
dependency orrelatedconditions ,orforpurposesof complying withthisConsent
Agreement, whether suchtreatment orevaluation occurred beforeorafter theeffective
dateofthisConsent Agreement. Totheextent permitted bylaw,theabove-mentioned
MEDICAL BOARD
CT 06 2010
JUSTINMATTHEWROEBAUGH,MD.
PAGE4
evaluativereports, summaries,and recordsare considered medical records for purposes
ofSection 149.43 ofthe Ohio Revised Codeand are confidential pursuantto statute. Dr.
Rodebaugh furtheragreesto providethe Board writtenconsent permittinganytreatment
providerfrom whom he obtainstreatmentto notifythe Board inthe eventhe faiIsto
agreeto or complywith any treatmentcontractor aftercarecontract. Failureto provide
suchconsent, or revocationofsuchconsent,shall constitutea violationofthis Consent
Agreement.
7. Dr. Rodebaugh shallsubmitquarterlydeclarations underpenaltyofBoard disciplinary
actionand /orcriminal prosecution,statingwhetherthere has beencompliancewith all
the conditionsofthisConsentAgreement. Thefirst quarterlydeclaration mustbe
received in the Board'sofficeson the date his quarterlydeclaration would have been due
pursuantto his September20I0 Step[ConsentAgreementwith the Board,or as
otherwiserequested by the Board. Subsequentquarterlydeclarationsmust be received
inthe Board'sofficeson or beforethe first day of everythird month.
8. Dr. Rodebaugh shall appearin person for an interview beforethe full Board or its
designated representativeon the date his first suchappearancewould have been
scheduled pursuantto his September2010Step[ConsentAgreementwith the Board.
Subsequent personal appearancesmustoccureverythreemonthsthereafter,and/oras
otherwiserequested by the Board. [fanappearance ismissed or isrescheduled for any
reason, ensuingappearancesshall be scheduled basedon the appearancedateas
originallyscheduled.
Drug& Alcohol Screens; DrugTestingFacilityand Collection Site
9. Dr. Rodebaugh shall submitto random urinescreeningsfor drugsand alcohol at least
four times per month, or as otherwisedirected by the Board. Dr. Rodebaughshall
ensurethatall screeningreportsare forwarded directly to the Board on aquarterly basis.
Thedrugtesting panel utilized must be acceptableto theSecretaryof the Board,and
shall include Dr. Rodebaugh'sdrug(s) ofchoice.
Dr. Rodebaughshall abstain from the use of any substanceand the consumptionof
poppyseedsor anyotherfood or liquid that may producea low level positiveresult in a
toxicologyscreen. Dr. Rodebaughacknowledgesthathe understandsthatthe
consumption or use ofsuchsubstances, including but not limited to substancessuchas
mouthwashor hand cleaninggel, may causea positivedrugscreenthatmay not be able
to be differentiated from intentional ingestion,and thereforesuch consumptionor use is
prohibited underthisConsentAgreement.
All such urine screeningsfor drugsand alcohol shall be conducted through a Board-
approved drugtesting facility and collection site pursuantto the globalcontractbetween
said facility and the Board, that providesfor the Board to maintain ultimatecontrol over
the urine screeningprocessand to preservethe confidentialityofall positivescreening
results in accordancewith Section4731.22(F)(5),OhioRevised Code,and the screening
MEDICAL BOARD
aCT 06 2010
JUSTIN MATTHEW ROEBAUGH, M.D.
PAGES
process shall require a daily call-in procedure. Further , in the event that the Board
exercises its discretion , as provided in Paragraph 10 below, to approve urine screenings
to be conducted at an alternative drug testing facility and/or collection site or a
supervising physician , such approval shall be expressly contingent upon the Board
retaining ultimate control over the urine screening process in a manner that preserves the
aforementioned confidential ity of all positi ve screening resuIts.
Dr. Rodebaugh shall submit, at his expense and on the day selected , urine specimens for
drug and/or alcohol analysis. All specimens submitted by Dr. Rodebaugh shall be
negative, except for those substances prescribed, admini stered, or dispensed to him in
conformance with the terms, conditions and limitations set forth in this Consent
Agreement. Refusal to submit such specimen, or failure to submit such specimen on the
day he is selected or in such manner as the Board may request, shall constitute a
Further, within thirty days of the effective date of this Consent Agreement, Dr.
Rodebaugh shall enter into the necessary financial and/or contractual arrangements with
the Board-approved drug testing facility and/or collection site in order to facilitate the
urine screening process in the manner required by this Consent Agreement. Further, Dr.
Rodebaugh shall promptly provide to the Board written documentation of completion of
such arrangements, including a copy of any contract entered into between Dr.
Rodebaugh and the Board-appro ved drug testing facil ity and/or collection site. Dr.
Rodebaugh 's failure to timely complete such arrangements, or failure to timely provide
written documentation to the Board of completion of such arrangements, shall constitute
a violation of this Consent Agreement.
Dr. Rodebaugh shall ensure that the urine screening process performed through the
Board-approved drug testing facility and/or collection site requires a daily call-in
procedure ; that the urine specimens are obtained on a random basis; and that the giving
of the specimen is witnessed by a reliable person. In addition, Dr. Rodebaugh and the
Board-approved drug testing facility and collection site shall assure that appropriate
control over the specimen is maintained and shall immediately inform the Board of any
positive screening results.
Dr. Rodebaugh shall ensure that the Board-approved drug testing facility and/or
collection site provides quarterly reports to the Board, in a format acceptable to the
Board, verifying whether all urine screens have been conducted in compliance with this
Consent Agreement , and whether all urine screens have been negati ve.
In the event that the Board-approved drug testing facility and/or collection site becomes
unable or unwilling to serve as required by this Consent Agreement , Dr. Rodebaugh
must immediatel y notify the Board in writing, and make arrangements acceptable to the
Board, pursuant to Paragraph 10 below, as soon as practicable. Dr. Rodebaugh shall
further ensure that the Board-approved drug testing facility and/or collection site also
notifies the Board directly of its inability to continue to serve and the reasons therefore.
MEDICA OARD
OCT 062010
SUPERSEDING STEP1CONSENT AGREEMENT
JUSTIN MATTHEW ROEBAUGH,M.D.
PAGE6
Dr. Rodebaughacknowledgesthatthe Board expressly reservesthe right to withdraw its
approval ofanydrugtestingfacility and/orcollectionsite in theeventthattheSecretary
and Supervising Memberofthe Board determinethatthedrugtestingfacility and/or
collectionsite has demonstrated a lack ofcooperation in providing informationto the
Board or for anyotherreason.
10. Dr. Rodebaughand the Board agreethat it is the intentofthis ConsentAgreementthat
Dr. Rodebaugh shall submithis urinespecimensto the Board-approveddrugtesting
facility and collection sitechosen by the Board. However, in theeventthatutilizingsaid
Board-approveddrug testing facility and /orcollectionsitecreatesan extraordinary
hardship upon Dr. Rodebaugh,as determined in the solediscretionofthe Board,then
subjectto the following requirements,the Board mayapprovean alternatedrugtesting
facility and/orcollection site, or a supervisingphysician,to facilitate the urinescreening
processfor Dr. Rodebaugh:
a. Within thirty daysofthe date upon which Dr. Rodebaugh is notified ofthe Board's
determinationthat utilizingthe Board-approveddrugtestingfacility and/or
collection siteconstitutesan extraordinary hardship upon Dr. Rodebaugh, he shall
submitto the Board in writingfor its priorapproval the identityof eitheran
alternatedrug testing facility and collection site, or the nameofa proposed
supervising physician, to whom Dr . Rodebaughshall submitthe required urine
specimens. Inapprovinga facility, entity,or an individual to servein thiscapacity,
the Board will givepreferenceto a facility located nearDr. Rodebaugh'sresidence
or employmentlocation, or to a physician who practices in the same localeas Dr.
Rodebaugh. Dr. Rodebaugh shall ensurethatthe urinescreening process
performed through the alternatedrug testingfacility and/orcollection site,or
through the supervisingphysician, requiresa dailycall-in procedure;thatthe urine
specimensareobtained on a random basis;and thatthegivingofthe specimen is
witnessed by a reliable person. In addition, Dr. Rodebaughacknowledgesthatthe
alternatedrug testingfacility and collectionsite, or the supervisingphysician, shall
assurethatappropriatecontrol overthe specimen is maintained and shall
immediately inform theBoard ofany positivescreeningresults.
b. Dr. Rodebaughshall ensurethatthe alternatedrug testingfacility and/orcollection
site,or thesupervising physician, providesquarterly reports to the Board, ina
formatacceptableto the Board,verifying whetherall urinescreenshave been
conducted incompliancewith thisConsentAgreement,and whetherall urine
c. In the eventthatthe designated alternatedrugtestingfacility and/orcollection site,
or the supervising physician, becomesunableor unwillingto so serve, Dr.
Rodebaugh must immediatelynotifythe Board in writing. Dr. Rodebaugh shall
furtherensurethatthe previouslydesignated alternatedrugtestingfacility and
MEDICAL BOARD
OCT 0 2010
PAGE7
collection site,orthesupervising physician,also notifies the Boarddirectly of the
inability tocontinue toserve and thereasons therefore. Further, inorder toensure
that there wi II benointerruption inhisurinescreening process,uponthe
previously approved alternate drug testing facility, collection site,orsupervising
physician becoming unable toserve, Dr.Rodebaugh shall immediately commence
urinescreeningatthe Board-approveddrug testing facilityandcollection site
chosen bythe Board,untilsuch time, ifany,thatthe Board approves asubsequent
alternate drug testing facility, collection site,orsupervisingphysician, ifrequested
byDr.Rodebaugh.
d. The Boardexpressly reserves therighttodisapproveanyentity or facility proposed
toserveas Dr.Rodebaugh's designated alternate drugtesting facility and/or
collection site,orany person proposed toserve ashissupervising physician, orto
withdraw approval of any entity, faci lity or person previously approved to so serve
intheevent that theSecretary andSupervising Member oftheBoard determine
thatanysuch entity, facility orperson hasdemonstrated a lackofcooperation in
providing information tothe Boardor foranyother reason.
11. Allscreeningreports required underthisConsent Agreement from theBoard-approved
drug testing facility and/or collection site,or fromthealternate drugtesting facility
and/or collection siteorsupervising physician, must bereceived inthe Board'soffices
no laterthan theduedate forDr.Rodebaugh's quarterly declaration. ItisDr.
Rodebaugh'sresponsibility toensure that reportsare timelysubmitted.
12. The Boardretains therighttorequire, and Dr.Rodebaugh agrees tosubmit, blood,urine,
breath,saliva and/or hairspecimensforscreening fordrugs andalcohol, foranalysis of
therapeutic levelsofmedications that may beprescribed forDr.Rodebaugh,orforany
other purpose,at Dr.Rodebaugh 's expense upon theBoard's request and without prior
notice.Dr.Rodebaugh'srefusal tosubmit aspecimen upon request of the Boardshall
result inaminimum ofoneyearofactual licensesuspension. Further, thecollection of
such specimensshall bewitnessed byarepresentativeofthe Board,oranother person
acceptabletotheSecretary orSupervisingMember ofthe Board.
Rehabilitation Program
13. Withinthirty daysoftheeffectivedateofthisConsent Agreement, Dr.Rodebaugh shall
undertake and maintain participation inanalcohol anddrug rehabilitation program,such
asA.A.,N.A.,c.A. , orCaduceus,no lessthan three times per week. Substitutionofany
other specific program mustreceive priorBoardapproval.
Dr.Rodebaugh shall submit acceptabledocumentaryevidenceofcontinuingcompliance
withthis program, including submission totheBoardofmeeting attendance Jogs,which
must bereceived intheBoard'soffices nolaterthan theduedate forDr.Rodebaugh's
quarterly declarations.
MEDICAL BOARD
OCT 06 lO/O
SUPERSEDINGSTEPICONSENT AGREEMENT
JUSTINMATTHEW ROEBAUGH,M.D.
PAGE8
14. Immedi ately upon completion of any required treatmentfor chemi cal dependency, Dr.
Rodebaugh shall enterinto an aftercarecontractwithaBoard-approvedtreatment
providerand shallmaintain continued compliance with the termsofsaid aftercare
contract, provided that, wherethetermsof the aftercarecontractconflictwith the terms
of this Consent Agreement, the termsof thi sConsent Agreement shall control.
15. TheBoard shall not considerreinstatementor restoration of Dr. Rodebaugh 'straining
certificate or issuanceof any other certifi cate to Dr. Rodebaugh until all of the following
conditionsare met:
a. Dr . Rodebaugh shall submitanapplication for reinstatementor restorati on ofhis
trainingcertificateoran appli cation for any othercertificate,as appropriate,
accompanied by appropriate fees, ifany.
b. Dr. Rodebaugh shalldemonstrateto the satisfact ionofthe Board that he can
resumepractice in compliancewith acceptableand prevailingstandards ofcare
under the provisions of his certificate. Such demonstration shall include but shall
not be limited to the following:
I. Certification from a treatmentprovidera pproved underSection4731.25 of
the Revised Code that Dr. Rodebaugh hassuccessfullycompleted any
required inpatienttreatment, includingat leasttwenty-ei ghtdaysof inpatient
or residentialtreatmentfor chemicalabu se/dependence,asset forth in Rules
4731-1 6-02 and 4731-1 6-08,Ohio Admini strati ve Code, completed
consecutivel y.
II. Evidence of continuing full compliance with,or successfulcomplet ion of, a
post-di scharge aftercare contract with atreatment provider approved under
Section473 I .25 of the Revised Code. Such evidenceshall include, but not
be limited to, a copy of the signed aftercare contract. The aftercare contract
must co mply with rule 4731-16-10 of the Administrat ive Code.
I ll. Evidence of continui ng full co mpliance with this Co nsent Agreement.
IV. Twowritten reportsindicatingthat Dr. Rodebaugh' s ability to practice has
been assessed and that he has been found capabl e of pra cti cing according to
acceptableand prevaiIing standards ofcare. Thereportsshall be madeby
physicians knowl edgeabl e in the area of addictionology and who are e ither
affiliated with acurrent Board-approved treatmentprovider orotherwise
have been approved inadvance by the Board to providean assessmentofDr.
Rodebaugh. Further,the two aforementioned physi ci ans shall not be
affiliated with the same treatmentprovider or medical group practi ce . Pri or
to the assessments, Dr. Rodebaugh shall providethe evaluatorswith copiesof
MEDICAL BOARD
[JCT 0 6 2010
SUPERSEDING STEP ICONSENT AGREEMENT
PAGE 9
patient records fromanyevaluationsand/or treatment that hehasreceived,
andacopyofthisConsent Agreement. The reports fromtheevaluatorsshall
includeany recommendations fortreatment, monitoring, orsupervision of
Dr. Rodebaugh,andanyconditions, restrictions, or limitations that should be
imposedon Dr.Rodebaugh's practice. The reports shallalso describe the
basis fortheevaluator'sdeterminations.
All reports required pursuant tothis paragraph shall bebasedupon
examinationsoccurring within thethree months immediately preceding any
application forreinstatement. Further,atthediscretion oftheSecretary and
Supervising Member ofthe Board,the Board may requestan updated
assessmentand report ifthe Secretary and Supervising Member determine
thatsuch updatedassessmentand report iswarranted forany reason.
v. Intheevent thatthe Board initiates future formal proceedings against Dr.
Rodebaugh, including butnot limitedto issuance ofaNotice ofOpportunity
for Hearing, Dr.Rodebaugh shall beineligible forreinstatement or
restoration ofhistraining certificate, or issuance ofanyother certificate, until
such proceedings arefully resolved byratification bytheBoardofa
subsequentConsentAgreement or issuance bythe Boardofafinal Board
Order.
c. Dr.Rodebaugh shallenter intoawritten consent agreement including probationary
terms, conditionsand limitationsasdetermined bythe Board within 180days of
thedate uponwhichalltheabove-specified conditions forreinstatementor
restoration ofhistraining certi ficateoranapplication forother certificate,as
appropriate, havebeencompleted or, ifthe Boardand Dr.Rodebaugh are unable
toagree onthetermsofawritten ConsentAgreement, then Dr.Rodebaugh further
agrees toabide byanyterms, conditionsand limitations imposed byBoardOrder
after a hearingconducted pursuant toChapter 119.of theOhio Revised Code.
The Board shall provide notice toDr.Rodebaugh thatsaid hearing hasbeen
scheduled,advising Dr.Rodebaugh ofhishearing rights, and stating thedate, time,
and locationofthe hearingatwhich the Boardwill present itsevidence,after
which the Boardwill makeadetermination ofthe matter byBoardOrder.
Further, uponreinstatementofDr.Rodebaugh's training certificate inthisstate, or
issuance ofanyother certificatetoDr.Rodebaugh bythe Board,the Board shall
require continued monitoring which shall include, butnot belimitedto,
compliancewith thewritten consent agreemententered into beforesuch
reinstatement,restoration,or issuance,orwithconditions imposed byBoard Order
after a hearingconducted pursuant toChapter 119.oftheRevised Code.
Moreover, upontermination oftheconsent agreementor BoardOrder, Dr.
Rodebaugh shall submit tothe Boardforat leasttwoyears annual progress reports
made under penalty ofBoarddisciplinary action orcriminal prosecution stating
whether Dr.Rodebaugh hasmaintained sobriety.
ME ICAl BOARD
OCT 062010
SUPERSEDING STEPJCONSENTAGREEMENT
PAGE 10
16. In the eventthat Dr. Rodebaugh has not been engaged in the active training and/or
practiceofmedicineand surgeryfor a period inexcessoftwo years priorto application
for reinstatementor restorationofhis trainingcertificateor application for any other
certificate, the Board may exercise itsdiscretion underSection4731.222, OhioRevised
Code, to requireadditional evidenceofDr. Rodebaugh'sfitness to resume practice.
17. Within thirty daysofthe effectivedateofthisConsentAgreement, Dr. Rodebaugh shall
provideacopyofthis ConsentAgreementto all employersor entitieswith which he is
undercontractto provide health careservices(including but not limited to third party
payors)or is receivingtraining; and the Chief ofStaffat each hospital where he has
privilegesor appointments. Further, Dr. Rodebaugh shall promptly provideacopyof
thisConsentAgreementto all employersor entitieswith which he contractsto provide
health careservices,or applies for or receives training, andthe ChiefofStaffat each
hospital wherehe appliesfor or obtainsprivilegesor appointments. In the eventthat Dr.
Rodebaugh providesany health careservicesor health caredirectionor medical
oversightto any emergency medical servicesorganizationor emergency medical
servicesprovider,within thirty daysofthe effectivedateof thisConsentAgreementDr.
Rodebaugh shall provideacopyofthis ConsentAgreementto the Ohio Departmentof
PublicSafety, DivisionofEmergencyMedical Services. Further, Dr. Rodebaugh shall
providethe Board with one ofthe following documentsas proofofeachrequired
notification withinthirtydaysof the dateof each such notification: (1) the return receipt
of certified mail within thirty days ofreceivingthatreturn receipt, (2) an
acknowledgementofdelivery bearingthe original ink signatureofthe personto whoma
copyofthe ConsentAgreementwas hand delivered, (3) the original facsimiIe-generated
reportconfirmingsuccessfultransmissionofacopyof the ConsentAgreementto the
personor entityto whom a copyofthe ConsentAgreementwasfaxed, or (4) an original
computer-generated printoutof electronicmail communicationdocumentingthe email
transmissionof a copyof the ConsentAgreementto the person or entityto whom a copy
of the ConsentAgreementwas emailed.
18. Within thirtydaysofthe effectivedateof thisConsentAgreement, Dr. Rodebaugh shall
providea copyofthisConsentAgreementto the properlicensingauthorityofany state
orjurisdiction inwhich he currentlyholdsany professional license, as well as any
federal agencyor entity, including but not limited to the Drug EnforcementAgency,
through which he currently holdsany licenseor certificate. Dr. Rodebaugh further
agreesto provideacopy ofthis ConsentAgreementat timeof application to the proper
licensingauthorityofany state inwhich he appliesfor any professional license or
reinstatementofany professional license. Further, Dr. Rodebaughshall providethe
Board with oneofthe following documentsas proofofeachrequired notification within
thirty daysofthe dateof eachsuch notification: (1) the return receiptofcertified mail
withinthirty daysofreceiving thatreturn receipt, (2) an acknowledgementof delivery
bearingtheoriginal ink signatureofthe person to whoma copyofthe Consent
MEDICAL OARD
DCr 0 2010
SUPERSEDING STEPJ CONSENT AGREEMENT
JUSTIN MATTHEWROEBAUGH,M.D.
PAGE II
Agreementwas hand delivered, (3) the original facsimile-generated reportconfirming
successful transmissionofacopyofthe ConsentAgreementto the personor entityto
whom a copyofthe ConsentAgreementwasfaxed, or (4) an originalcomputer-
generated printoutofe lectronic mailcommunicationdocumentingthe email
transmissionof a copy of the Consent Agreement to the person or entity to whom a co py
of the ConsentAgreementwa s emailed.
19. Dr. Rodebaugh sha ll promptl y provide a copy of this Consent Agreement to all persons
and entities that provide Dr. Rod ebaugh chemica ldependency treatmentor monitoring.
Further, Dr. Rodebaugh sha ll pro vide the Board with one of the following documents as
proof of each requi red notifi cat ion within thirty days of the date of ea ch such
notification: (1) the return receiptof cert ified mail within thirty days of recei ving that
return receipt, (2)an acknowl edgementofdelivery bearing theori ginal ink signatureof
the person to whom a copy of the Co nsentAgreement wa s hand delivered, (3) the
ori ginal facsim iIe-generated reportconfirming successfuI tran smi ssion of a copy of the
Co nse nt Agreement to the per son or entity to whom a copy of the Co nse nt Agreement
was faxed, or (4) an ori ginal computer-generated printout of electroni c mail
communicationdocumenting theemail transmissionofa copyofthe Consent Agreement
to the per son or entity to whom a copy of the Consent Agreement wa s emaiJed.
20. Dr. Rodebaugh shallnotify the Board in writingof anychangeofprincipal practice
addressorresidence address within thirty daysofsuchchange.
DURATIONIMODIFICATIONOFTERMS
Theabove-described terms ,conditionsand limitationsmay be amendedor terminated in writing at
any time upon theagreementofboth parties. In the eventthatthe Board initiates future formal
proceedingsagainst Dr. Rodebaugh, including but not limited to issuanceofa Noticeof
Opportunityfor Hearing,th isConsentAg reementsha llcontinue in full force and effect until such
timethat it is superseded by ratifi cat ion by the Board ofa subsequentConsentAgree mentor
issuance by the Board ofa final BoardOrder.
In the event that any term, limitat ion, or condition conta ined in thi s Consent Ag reement is
determined to be invalid by acourtof competentjurisdi cti on, Dr. Rodebaugh and the Board agr ee
thatall otherterms, limitati ons,and condi tions contained in thi sConsentAgreementshallbe
unaffected.
FAILURETOCOMPLY
If, in the dis cr etion of the Sec retary and Supervising Member of the Board, Dr. Rodebaugh appears
to have violated or brea ched any term orconditionof thisConsentAgreement, the Board reserves
the rightto institute formal di sciplinary proceedings for anyand all possibleviolationsor breaches,
including but not limited to, a lleged vi ol at ionsof the lawsof Ohio occurring before the effective
dateofthis ConsentAgreement.
ACKNOWLEDGMENTS/LIABILITYRELEASE
MEDICALBOARD
JeT 06 2010
PAGE 12
Dr . Rod ebaugh acknowledgesthat he has had an opport unity to askquestions concerningthe terms
ofthis ConsentAgreementand that allquest ions asked have beenanswered inasa tisfactory
manner.
Any act ion initiated by the Board based on a lleged violations of thi s Co nse nt Ag ree ment sha ll
comply with the Administrat ive Procedure Act, Cha pte r 11 9. , Ohi o Revised Code .
Dr. Rodebaugh hereby releases the Board , its members, employees, agents, office rs and
rep resentati ves j ointl y and severally from any andall liability ari sin g from the within matter.
ThisConsentAg ree mentshall beconsid ered a publi c record as that term is used in Sect ion 149.4 3,
Ohio Revi sed Code . Furt her, this informati on may be reported to appropriate orga niza tions, dat a
banks and governme nta l bodi es. Dr. Rodebaugh acknowledges that his social sec urity number will
be used if thi s informati on is so reported and ag rees to provide his soc ial sec urity number to the
Board for suc hpurposes.
EFFECTIVEDATE
It is ex press ly und er stood that thi sConsent Ag ree me nt is subj ect to ratificati on by the Board pri or
to s ignature by the Secretaryand Supervisin g Member and sha llbecomeeffective upon the last dat e
of signature bel ow. Further , the aforementi oned Se ptember 20 10 Step IConse ntAgree ment sha ll
be term inated upon thi s Superseding Step [Conse nt Ag ree me nt becomingeffective .

Secretary
DATE DATE
Attorneyfor Dr. Rodebaugh
DATE I
MEDICAL OARD
OCT 06 2010
SUPERSEDI NG STEP I CONSENT AGREEMENT
PAGE 13
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STEPI
CONSENTAGREEMENT
BETWEEN
JUSTINMATTHEWRODEBAUGH,M.D
AND
THESTATEMEDICALBOARDOFOHIO
ThisConsentAgreement isentered into by and betweenJustin Matthew Rodebaugh, M.D., [Dr.
Rodebaugh], and the StateMedical Board ofOhio [Board], a stateagencycharged with enforcing
Chapter473 I .,Ohio Revised Code.
Dr. Rodebaughenters into this ConsentAgreementbeingfully informedofhis rights underChapter
119., Ohio Revised Code, includingthe rightto representation by counsel and the rightto a formal
adjudicative hearing on the issuesconsidered herein.
BASIS FORACTION
ThisConsentAgreement isentered into on the basisofthe followingstipulations,admissionsand
understandings:
A. TheBoard isempoweredby Section4731.22(B),Ohio Revised Code,to limit ,revoke,
suspend a certificate, refuseto registeror reinstatean applicant,or reprimand or placeon
probation the holderof a certificatefor violation of Section4731.22(B)(26),Ohio
Revised Code, for "impairmentofability to practiceaccordingto acceptableand
prevailing standardsof care becauseofhabitualor excessive use or abuseofdrugs,
alcohol ,or othersubstancesthat impairability to practice."
B. TheBoard enters into this ConsentAgreementin lieu offormal proceedingsbased upon
the violationofSection4731.22(B)(26),OhioRevisedCode,as set forth in Paragraph E
below,and expressly reservesthe rightto institute formal proceedingsbased upon any
otherviolationsofChapter473].ofthe Revised Code,whetheroccurringbeforeor after
the effectivedateofthisAgreement.
C. Dr. Rodebaugh holdsatrainingcertificate inthe Stateof Ohio, License#57. 0154]8.
D. Dr.Rodebaugh statesthat he doesnot hold atrainingcertificate, noris he licensed to
practicemedicineor surgery, inany otherstateorjurisdiction.
E. Dr. Rodebaugh admits that on or aboutAugust5, 2010, he self-reported to the Board,
through his legal counsel , that he had relapsed on alcohol. Dr . Rodebaugh further
admitsthathe initiallyentered treatmentfor alcohol addictionat Glenbeigh,a Board
approved treatmentprovider in RockCreek,Ohio, inOctober2009,where hecompleted
STEPICONSENT AGREEMENT
JUSTINMATTHEW RODEBAUGH,M.D.
PAGE2
twenty-eight daysofin-patienttreatment. Dr.Rodebaughadmitsthathisdrugofchoice
isalcoholandthat inorabout December2009, herelapsedonalcohol byconsuming
vodka. Dr.Rodebaughadmitsthat heenteredtreatmentfor hisrelapseatGlenbeigh on
oraboutJuly20,20IO. Dr.Rodebaughacknowledges thatheiscurrently impairedin
hisabilitytotrain inthepracticeofmedicineandsurgeryaccording toacceptable and
prevailingstandardsof care. Dr.Rodebaughspecifically deniesinappropriate useof any
controlled substance.
AGREED CONDITIONS
Wherefore, in consideration of the foregoing and mutual promises hereinafter set forth, and inJ ieu
ofany format proceedingsatthistime,Dr.Rodebaugh knowinglyandvoluntarily agrees withthe
BoardtothefoJJowing terms,conditions and limitations:
SUSPENSION OF CERTIFICATE
1. Thetrainingcertificate ofDr.Rodebaugh intheStateofOhioshall beSUSPENDED for
an indefinite periodoftime,butnotlessthan90days. Duringsuchsuspension, Dr.
Rodebaughshall beineligibletoreceiveorholdanyothercertificate issued bythe
Board.
ObeyallLaws
2. Dr.Rodebaughshallobeyall federal,state,and locallaws.
Sobriety
3. Dr. Rodebaugh shallabstaincompletely from the personal use or personal possessionof
drugs,except those prescribed,dispensed oradministered tohimbyanotherso
authorized bylawwhohasfullknowledgeofDr.Rodebaugh's historyofchemical
dependency. Further,intheevent thatDr.Rodebaugh issoprescribed,dispensed or
administered anycontrolled substance,carisoprodol, ortramadol,Dr.Rodebaugh shall
notifytheBoard inwriting withinsevendays, providingtheBoardwiththeidentityof
theprescriber; the nameof the drug Dr. Rodebaugh received;themedical purposefor
which hereceivedsaiddrug;thedatesuchdrugwas initiallyreceived;andthedosage,
amount, numberofrefilJs,anddirections foruse. Further, withinthirtydaysofthedate
saiddrug issoprescribed,dispensed,oradministered to him,Dr.Rodebaugh shall
providetheBoardwitheitheracopyofthewrittenprescription orother written
verificationfromtheprescriber, includingthedosage,amount,numberofrefills,and
directions foruse.
4. Dr.Rodebaughshallabstaincompletely fromtheuseofalcohol.
STEP ICONSENT AGREEMENT
PAGE3
Absencesfrom Ohio
5. Dr. Rodebaugh shall obtain permissionfrom the Board for departuresor absences from
Ohio. Such periodsof absence shall not reduce the probationary term, unl ess otherwise
determined by motionof the Board for absences of three months or longer, or by the
Secretaryor the Supervising Memberofthe Board for absencesofless thanthree
months, in instanceswhere the Boardcan be assured thatprobationary monitoring is
otherwi se being performed. Furt her,the Secretaryand Supervising Memberofthe
Board shall have the discretion to grantawaiverof part or all of the monitoringterms
set forth inthi sConsentAgreementfor occasional periodsof absenceof fourteen daysor
less. Inthe eventthat Dr. Rodebaugh residesand/orisemployed at a location thatis
within fifty miles of the geographic borderof Ohio and any of its contiguous states, Dr.
Rodebaugh may travel between Ohioand that contiguousstatewithoutseekingprior
approval ofthe Secretaryor SupervisingMemberprovided thatDr. Rodebaugh isable to
otherwisemaintain full compliancewith all otherterms,conditionsand limitationsset
forth inthi s ConsentAgreement.
Releases;Quarterly Declarationsand Appearances
6. Dr. Rodebaugh shall provideauthorization,through appropriatewrittenconsentforms,
for discl osure of evaluative reports, summaries, and records,of whatever nature, by any
and all partiesthatprovidetreatmentor evaluati on for Dr. Rodebaugh'schemical
dependency orrelated conditions,orfor purposes of complyingwith this Consent
Agreement,whethersuchtreatmentor evaluati on occurred beforeor afterthe effective
date of thi sConsent Agreement. To the extent permitted by law, the abo ve-mentioned
evaluativereports, summaries,and recordsare considered medical recordsfor purposes
of Section 149.43of the Ohi o Revised Code and are confidentia l pursuant to statute. Dr.
Rodebaugh furtheragreesto providethe Board written consentpermittingany treatment
providerfrom whom he obtainstreatmentto noti fy the Board inthe eventhe fail sto
agreeto orcomplywithany treatmentcontractoraftercarecontract. Failureto provide
such con sent, or revocationof such consent, shall con stitute a violationof this Con sent
Agreement.
7. Dr. Rodebaugh shall submit quarterl y decl arati ons under penalty of Board di sciplinary
actionand/orcriminal prosecution, stat ing whetherthere has been compliancewith all
the conditi ons ofthis ConsentAgreement. Thefirst quarterly declarati on must be
received inthe Board ' sofficeson the first day of the third month foll owingthe month in
whi ch thi sCon sentAgreementbecomeseffecti ve,orasotherwise requested by the
Board. Subsequentquarterl y declarationsmustbe received inthe Board'soffices on or
before the first day of every third month.
8. Dr. Rodebaugh shallappearin pers on for an interview beforethe fuJI Board or its
designated repre sentati ve during the third monthfollowingthe effect ive dateof thi s
Con sentAgreement. Subsequent per sonal appearancesmust occurevery three months
STEP [CONSENTAGREEMENT
JUSTIN MATTHEW RODEBAUGH,MD.
PAGE4
thereafter, and/oras otherwise requested bythe Board. Ifan appearance is missed or is
rescheduled for any reason, ensuingappearancesshall be scheduled based on the
appearancedateas originallyscheduled.
Drug& Alcohol Screens; DrugTesting Facilityand CollectionSite
9. Dr. Rodebaughshall submitto random urinescreeningsfor drugsand alcohol at least
fourtimes per month,or as otherwisedirected by the Board. Dr. Rodebaugh shall
ensurethatall screeningreportsare forwarded directly to the Boardon a quarterly basis.
Thedrugtesting panel utilized must beacceptableto the Secretaryofthe Board,and
shall includeDr. Rodebaugh'sdrug(s)of choice.
Dr. Rodebaugh shall abstainfrom the use of any substanceand the consumptionof
poppyseedsor any otherfood or liquid thatmay producea low level positiveresult in a
toxicology screen. Dr. Rodebaughacknowledgesthat he understandsthatthe
consumptionor use ofsuch substances, including but not limited to substancessuch as
mouthwashor hand cleaninggel, may causea positivedrugscreenthatmay not be able
to be differentiated from intentional ingestion,and thereforesuchconsumptionor use is
prohibited underthis ConsentAgreement.
All such urinescreeningsfor drugsand alcohol shall be conducted through a Board-
approved drugtestingfacility and collectionsitepursuantto the global contract between
said facility and the Board, that providesfor the Board to maintain ultimatecontrol over
the urinescreening processand to preservethe confidentialityofall positivescreening
results in accordancewith Section4731.22(F)(5),Ohio Revised Code,and the screening
processshall requirea dailycall-in procedure. Further, inthe eventthatthe Board
exercises itsdiscretion,as provided in Paragraph 10below,to approveurinescreenings
to be conducted at an alternativedrugtestingfacility and/orcollection siteor a
supervisingphysician,suchapproval shall be expresslycontingentupon the Board
retaining ultimatecontrol overthe urinescreeningprocess ina mannerthat preservesthe
aforementioned confidentialityof all positivescreeningresults.
Dr .Rodebaughshall submit,at his expenseand on the day selected, urinespecimens for
drugand/oralcoholanalysis. All specimenssubmitted by Dr. Rodebaughshall be
negative, exceptfor thosesubstancesprescribed,administered, or dispensed to him in
conformancewith the terms,conditionsand limitationsset forth in this Consent
Agreement. Refusal to submitsuch specimen,or failure to submitsuchspecimenon the
day he isselected or insuch manneras the Board may request, shallconstitutea
violationofthis ConsentAgreement.
Further, withinthirty daysofthe effectivedateof this ConsentAgreement, Dr.
Rodebaugh shall enterinto the necessaryfinancial and/orcontractual arrangementswith
the Board-approveddrugtestingfacility and/orcollectionsite inorderto facilitate the
urinescreeningprocess inthe mannerrequired by thisConsentAgreement. Further, Dr.
STEPf CONSENTAGREEMENT
PAGE5
Rodebaughshall promptly providetotheBoard writtendocumentation ofcompletion of
sucharrangements,including acopyofanycontract entered intobetween Dr.
Rodebaughandthe Board-approved drugtestingfacility and/orcollection site. Dr.
Rodebaugh'sfailuretotimelycomplete sucharrangements,orfailure totimely provide
written documentation to theBoardof completion of such arrangements, shall const itute
aviolationofthisConsent Agreement.
Dr.Rodebaugh shallensure thattheurinescreening process performed through the
Board-approved drugtesting facility and/orcollection siterequires adailycall-in
procedure;thattheurinespecimensareobtained onarandom basis;and thatthegiving
ofthespecimeniswitnessed byareliable person. In addition,Dr.Rodebaugh andthe
Board-approved drugtesting facilityandcollection siteshallassure thatappropriate
control overthespecimen ismaintained andshall immediately informtheBoardofany
positivescreeningresults.
Dr. Rodebaugh shallensure thattheBoard-approved drug testing facilityand/or
collection siteprovidesquarterly reportstothe Board, inaformat acceptable tothe
Board,verifying whether all urinescreenshavebeenconducted incompliance with this
Consent Agreement ,andwhether allurinescreenshavebeen negative.
In theeventthat theBoard-approved drugtesting facility and/orcollection site becomes
unableorunwilling toserveasrequired bythisConsent Agreement, Dr.Rodebaugh
must immediatelynotifytheBoardinwriting,and makearrangement sacceptable tothe
Board,pursuant toParagraph 10below,assoonaspracticable. Dr.Rodebaugh shall
further ensure thattheBoard-approved drugtesting facilityand/orcollection sitealso
notifiestheBoarddirectly ofitsinabilitytocontinue toserveandthereasonstherefore.
Dr.Rodebaughacknowledgesthatthe Boardexpresslyreservestherighttowithdraw its
approval ofanydrugtesting facilityand/orcollection siteintheevent thattheSecretary
and Supervising MemberoftheBoard determine thatthedrugtesting facilityand/or
collection site has demonstrated a lackof cooperation in providing information to the
Board orforanyotherreason.
10. Dr. Rodebaugh andtheBoardagreethat itistheintentofthisConsent Agreement that
Dr.Rodebaugh shallsubmithisurinespecimenstotheBoard-approved drug testing
facility andcollection sitechosen bytheBoard. However, intheeventthat utilizing said
Board-approved drugtesting facilityand/or collection sitecreatesanextraordinary
hardship uponDr.Rodebaugh,asdetermined inthesolediscretionof theBoard,then
subject tothefollowing requirements,theBoardmayapprove analternate drugtesting
facility and/orcollectionsite,orasupervising physician, tofacilitate theurinescreening
processforDr.Rodebaugh:
a. Within thirty daysof the date upon which Dr. Rodebaugh is notifiedof the Board' s
determination thatutilizing the Board-approved drugtesting facilityand/or
STEPICONSENTAGREEMENT
PAGE6
collection site constitutesan extraordinaryhardship upon Dr. Rodebaugh, he shall
submitto the Board inwritingfor its priorapproval the identity of eitheran
alternatedrugtestingfacility and collectionsite,or thenameofaproposed
supervising physician,to whom Dr. Rodebaugh shall submittherequired urine
specimens. Inapprovinga facility,entity,or an indi vidual to serve inthi scapacity,
the Board will givepreferenceto a facility located nearDr. Rodebaugh'sresidence
or employmentlocation, or to a physicianwho practices inthe same localeas Dr.
Rodebaugh. Dr. Rodebaughshallensurethatthe urinescreening process
performed through the alternatedrug testing facility and /orcollectionsite, or
throughthe supervising physician, requiresa dailycall-in procedure; that the urine
specimens are obtained on a random basi s; and thatthegivingofthespecimen is
witnessed by a reliable per son . In addition, Dr. Rod ebaughacknowledges thatthe
alternatedrugtesting facility and collectionsite, or the supervising physician, shall
assurethatappropri ate control overthe specimen is maintained and shall
immediatelyinform the Board ofany positive screening results.
b. Dr. Rodebaughshall ensure thatthe alternatedrugtestingfacility and/or collection
site,or thesupervising physician, providesquarterly reports to the Board, ina
formatacceptabletothe Board , verifying whetherall urinescreenshave been
co nducted incompliancewith thisConsentAgreement,and whetherall urine
c. In the eventthatthe designated alternate drugtestingfacility and/orcollection site,
or the supervisingphysician, becomes unableor unwillingto so serve, Dr .
Rodebaugh must immediately noti fy the Board inwriting. Dr. Rodebaughshall
furtherensurethatthe previ ously de signatedalternatedrugtestingfacility and
collectionsite,or the supervising physi cian, also notifiesthe Board directl y of the
inabili ty to continueto serve and the reasons the refore. Further, inorderto ensure
thattherewill be no interrupti on in his urinescreening process, upon the
previouslyapproved a lternatedrugtestingfacility,collection site,or supervising
physi cian becomingunableto serve, Dr. Rodebaugh sha llimmediatel ycommence
urinescreeningat the Board-approveddrugtestingfacility and collect ionsite
chosen by the Board, until such time, if any,that the Board approvesa subsequent
alternate drug testing facili ty, collection site, or superv isi ng physician, ifrequested
by Dr. Rodebaugh.
d. TheBoard expressly reserves the rightto disapproveany entityor facility proposed
to serve as Dr. Rodebaugh' sdesignated alternatedrugtesting facilityand/or
collectionsite,or any person proposed to serveas his supervising physici an,or to
withdraw approvalof anyent ity, facili ty or person pre viousl y approved to so serve
inthe eventthatthe Secretaryand Supervising Memberofthe Boarddetermine
thatany such entity,facility or person has demonstrated a lack of cooperat ion in
providing information to the Board orfor anyotherreason.
STEP1CONSENTAGREEMENT
PAGE7
II . All screeningreportsrequired underthisConsentAgreementfrom the Board-approved
drugtestingfacility and/orcollectionsite, or from the alternatedrugtestingfacility
and/orcollectionsiteor supervisingphysician, mustbe received inthe Board'soffices
no laterthan the due date for Dr. Rodebaugh 'squarterlydeclaration. It isDr.
Rodebaugh'sresponsibilityto ensurethatreportsare timely submitted.
12. The Board retainsthe rightto require, and Dr. Rodebaugh agreesto submit, blood, urine,
breath,saliva and/orhairspecimensfor screeningfor drugs and alcohol,for analysisof
therapeutic levelsofmedicationsthatmay be prescribed for Dr. Rodebaugh, or for any
otherpurpose,at Dr. Rodebaugh'sexpenseupon the Board'srequestand withoutprior
notice. Dr. Rodebaugh'srefusal to submita specimenupon requestofthe Boardshall
result in a minimumof oneyearofactual licensesuspension. Further, thecollectionof
such specimensshall be witnessed by a representativeof the Board, or anotherperson
acceptableto the Secretary or SupervisingMemberof the Board.
Rehabilitation Program
13. Withinthirtydaysof the effectivedateofthisConsentAgreement, Dr. Rodebaughshall
undertakeand maintain participation inan alcohol and drug rehabilitation program, such
as A.A., N.A., c.A., or Caduceus, no less than threetimesper week. Substitutionof any
otherspecificprogram mustreceive prior Boardapproval.
Dr. Rodebaugh shall submitacceptabledocumentaryevidenceof continuingcompliance
with this program, includingsubmissionto the Board ofmeetingattendance logs, which
must be received in the Board'sofficesno laterthan the due datefor Dr. Rodebaugh's
quarterlydeclarations.
14. Immediately upon completionof any required treatment for chemicaldependency, Dr .
Rodebaugh shall enterinto an aftercarecontractwith a Board-approved treatment
providerand shall maintaincontinued compliancewith the termsofsaid aftercare
contract, provided that, wherethe termsof the aftercarecontractconflictwith the terms
ofthis ConsentAgreement,the termsofthis ConsentAgreementshall control.
15. TheBoardshall not considerreinstatementor restoration ofDr. Rodebaugh'straining
certificateor issuanceof any othercertificateto Dr. Rodebaugh until all ofthe following
conditionsare met:
a. Dr. Rodebaugh shall submitan application for reinstatementor restorationofhis
trainingcertificateor an application for any othercertificate,as appropriate,
accompanied by appropriatefees , ifany.
STEP ICONSENT AGREEMENT
JUSTINMATTHEWRODEBAUGH,MD.
PAGE8
b. Dr. Rodebaughshall demonstrateto the satisfactionof the Board that he can
resume practice incompliancewith acceptableand prevailingstandardsof care
underthe provisionsofhis certificate. Such demonstration shall include but shall
not be limited to the following:
I. Certification from atreatmentproviderapproved underSection4731.25 of
the Revised Codethat Dr. Rodebaugh has successfullycompleted any
required inpatienttreatment, includingat leasttwenty-eightdaysofinpatient
or residential treatmentfor chemical abuse/dependence, as set forth in Rules
4731-16-02and 4731-16-08,OhioAdministrativeCode,completed
consecutively.
II. Evidenceofcontinuing fuII compliancewith, or successful completion of, a
post-dischargeaftercarecontractwith a treatmentproviderapproved under
Section4731.25 ofthe Revised Code. Suchevidenceshall include, but not
be limited to, a copyofthe signed aftercarecontract. Theaftercarecontract
mustcomplywith rule 4731-16-10ofthe AdministrativeCode.
Ill. Evidenceofcontinuingfull compliancewith this ConsentAgreement.
IV. Twowritten reports indicatingthat Dr. Rodebaugh'sabilityto practicehas
been assessedand thathe has been found capableofpracticingaccordingto
acceptableand prevailingstandardsof care. Thereportsshall be made by
physiciansknowledgeable inthe areaofaddictionologyand whoare either
affiliated witha currentBoard-approved treatment provideror otherwise
have been approved inadvanceby the Board to providean assessmentofDr.
Rodebaugh. Further,the twoaforementioned physiciansshall not be
affiliated with the sametreatmentprovideror medical grouppractice. Prior
to the assessments, Dr. Rodebaughshall providetheevaluatorswithcopiesof
patient recordsfrom any evaluationsand/ortreatmentthat he has received,
and acopyofthisConsentAgreement. Thereports from the evaluatorsshall
includeany recommendationsfor treatment, monitoring,or supervisionof
Dr. Rodebaugh,and any conditions, restrictions,orlimitationsthat should be
imposed on Dr. Rodebaugh's practice. Thereportsshall also describethe
basisfor the evaluator'sdeterminations.
All reportsrequired pursuantto this paragraph shall be based upon
examinationsoccurringwithin thethree monthsimmediately precedingany
application for reinstatementor restoration ofhis trainingcertificateor
application for any othercertificate. Further,at the discretionof the
Secretaryand SupervisingMemberof the Board,the Board may requestan
updated assessmentand report ifthe Secretaryand SupervisingMember
determinethatsuch updated assessmentand report iswarranted for any
reason.
STEP ICONSENTAGREEMENT
JUSTIN MATTHEWRODEBAUGH,M.D.
PAGE9
v. Inthe eventthatthe Board initiatesfuture formal proceedingsagainstDr.
Rodebaugh, including but not limited to issuanceofaNoticeofOpportunity
for Hearing, Dr . Rodebaugh shall be ineligiblefor reinstatementor
restorationofhis trainingcertificate,or issuanceof any othercertificate, until
such proceedingsare fully resolved by ratification by the Board ofa
subsequentConsentAgreementorissuance by the Boardof a final Board
Order.
c. Dr. Rodebaughshall enterinto a writtenconsentagreement including probationary
terms, conditionsand limitationsas determined by the Board within 180daysof
the dateupon whichall the above-specifiedconditionsfor reinstatementor
restorationofhis trainingcertificateor an applicationfor othercertificate,as
appropriate, have been completed or, ifthe Board and Dr. Rodebaughare unableto
agreeon the termsof a writtenConsentAgreement, then Dr. Rodebaugh further
agreesto abide by any terms, conditionsand limitations imposed by Board Order
aftera hearingconducted pursuantto Chapter 119. ofthe OhioRevised Code.
TheBoardshall providenoticeto Dr. Rodebaughthatsaid hearing has been
scheduled, advising Dr. Rodebaughofhis hearing rights, and statingthe date,time,
and locationof the hearingat which the Board will present itsevidence,after
whichthe Board will makeadeterminationofthe matterby Board Order.
Further, upon reinstatementor restorationofDr. Rodebaugh' s trainingcertificate
inthis stateor issuanceof any othercertificateto Dr. Rodebaugh by the Board,the
Board shall requirecontinued monitoringwhich shall include, but not be limited
to, compliancewith the writtenconsentagreemententered into before
reinstatementor withconditions imposed by BoardOrderaftera hearing
conducted pursuanttoChapter 119. ofthe Revised Code. Moreover,upon
terminationof the consentagreementor Board Order,Dr. Rodebaugh shall submit
to the Board for at leasttwo yearsannual progressreports madeunder penaltyof
Boarddisciplinaryactionor criminal prosecution statingwhetherDr. Rodebaugh
has maintained sobriety.
16. In the eventthat Dr. Rodebaugh has not been engaged in the activetrainingand/or
practiceofmedicineand surgeryfor a period inexcessoftwoyearspriorto application
for reinstatementor restorationofhis trainingcertificateor application for any other
certificate,the Board may exercise itsdiscretion underSection473].222,Ohio Revised
Code,to requireadditional evidenceofDr. Rodebaugh'sfitness to resume practice.
17. Within thirtydaysofthe effectivedateofthis ConsentAgreement, Dr .Rodebaughshall
provideacopyofthis ConsentAgreementto all employersor entitieswith which he is
undercontractto provide health careservices(including but not limited to third party
PAGE 10
payors)or is receivingtraining; and the ChiefofStaffat each hospital where he has
privilegesor appointments.Further, Dr. Rodebaugh shall promptly provideacopyof
this ConsentAgreementto all employersor entitieswith which hecontractsto provide
health care services, or applies for or receives training, and the Chief of Staff at each
hospital wherehe applies for or obtainsprivilegesor appointments. Inthe eventthat Dr.
Rodebaugh providesany health careservicesor health caredirectionor medical
oversightto any emergency medical servicesorganizationor emergency medical
services provider, withinthirty daysof the effectivedateofthisConsentAgreement Dr.
Rodebaugh shall provideacopyofthis ConsentAgreementto the Ohio Departmentof
PublicSafety, Divisionof Emergency Medical Services. Further, Dr. Rodebaugh shall
providethe Board with one ofthe following documentsas proofof each required
notification within thirty daysofthe dateof eachsuch notification: (I)the return receipt
ofcertified mail within thirty daysofreceivingthatreturn receipt ,(2) an
acknowledgementof delivery bearingthe original ink signatureofthe person to whoma
copyofthe ConsentAgreementwas hand delivered,(3) the original facsimile-generated
reportconfirmingsuccessful transmission ofacopyofthe ConsentAgreementto the
person or entityto whoma copyofthe ConsentAgreementwas faxed, or (4) an original
computer-generated printoutof electronicmail communicationdocumentingthe email
transmissionof a copyofthe ConsentAgreementto the personor entityto whom a copy
ofthe ConsentAgreementwas emaiJed.
18. Within thirtydaysofthe effectivedateofthis ConsentAgreement, Dr. Rodebaughshall
providea copy of this ConsentAgreementto the properlicensingauthorityof any state
orjurisdiction inwhich he currently holdsany professional license, as well as any
federal agencyor entity, including but not limited to the Drug EnforcementAgency,
through which he currentlyholdsany licenseor certificate. Dr. Rodebaugh further
agreesto providea copy ofthis ConsentAgreementat timeofapplicationto the proper
licensingauthorityof any state in which he applies for any professional licenseor
reinstatementof any professional license. Further, Dr. Rodebaughshall providethe
Board with oneofthe following documentsas proofof each required notification within
thirtydaysofthe dateofeachsuch notification: (I)the return receiptof certified mail
withinthirty daysofreceiving thatreturn receipt, (2) an acknowledgementof delivery
bearingtheoriginal ink signatureofthe person to whomacopyofthe Consent
Agreementwas hand delivered,(3) the original facsimile-generated reportconfirming
successfultransmissionof a copy ofthe ConsentAgreementto the person or entityto
whoma copyofthe ConsentAgreementwas faxed, or (4) an original computer-
generated printoutof electronicmail communicationdocumentingthe email
transmissionofacopyofthe ConsentAgreementto the person or entity to whom a copy
ofthe ConsentAgreementwasemailed.
19. Dr .Rodebaughshall promptly provideacopyof this ConsentAgreementto all persons
and entitiesthat provideDr. Rodebaughchemicaldependencytreatmentor monitoring.
Further, Dr. Rodebaugh shall providethe Boardwithoneof the following documentsas
proofof each required notification within thirtydaysofthe dateof each such
JUSTIN MATTHEW RODEBAUGH,M.D.
PAGE II
notification: (1) the return receiptof certified mail within thirty daysofreceivingthat
return receipt,(2) an acknowledgementof delivery bearingthe original ink signatureof
the person to whoma copyof the ConsentAgreementwashand delivered,(3) the
original facsimile-generated report confirmingsuccessful transmissionofacopyofthe
ConsentAgreementto the personor entityto whoma copyofthe ConsentAgreement
wasfaxed, or (4) an originalcomputer-generated printoutofelectronic mail
communicationdocumentingtheemail transmissionof acopyofthe ConsentAgreement
to the personor entityto whoma copyof the ConsentAgreementwasemailed.
20. Dr. Rodebaugh shall notify the Board inwritingofanychangeofprincipal practice
addressorresidenceaddress within thirty daysof such change.
DURATIONIMODIFICATION OF TERMS
Theabove-describedterms, conditionsand limitationsmay be amended or terminated in writingat
anytime upontheagreementofboth parties. Jnthe eventthatthe Board initiatesfuture formal
proceedingsagainstDr. Rodebaugh, including but not limited to issuanceof aNoticeof
Opportunityfor Hearing,thisConsentAgreementshall continue infull force and effectuntil such
timethat it is superseded by ratification by the Board of a subsequentConsentAgreementor
issuance by the Boardofafinal BoardOrder.
In the eventthatanyterm, limitation, or condition contained inthisConsentAgreement is
determined to be invalid by a courtof competentjurisdiction,Dr. Rodebaugh and the Board agree
thatall otherterms, limitations,and conditionscontained inthisConsentAgreementshall be
unaffected.
FAILURE TO COMPLY
If, inthe discretion of the Secretaryand SupervisingMemberof the Board, Dr. Rodebaughappears
to have violated or breachedanyterm or conditionofthis ConsentAgreement, the Board reserves
the rightto instituteformal disciplinary proceedingsfor any and all possibleviolationsor breaches,
including but not limited to,alleged violationsofthe laws ofOhiooccurringbeforethe effective
dateof thisConsentAgreement.
ACKNOWLEDGMENTSILIABILITY RELEASE
Dr. Rodebaughacknowledgesthat he has had an opportunityto askquestionsconcerningthe terms
of thisConsentAgreementand that all questionsasked have been answered ina satisfactory
manner.
Anyaction initiated by the Board based on alleged violationsofthisConsentAgreementshall
complywith the AdministrativeProcedureAct, Chapter]19., Ohio Revised Code.
STEP I CONSENT AGREEMENT
PAGE 12
Dr. Rodebaugh hereby releases the Board, its members, employees, agents, officers and
representatives jointly and severally from any and all liability arising from the within matter.
This Consent Agreement shall be considered a public record as that term is used in Section 149.43,
Ohio Revised Code. Further, this information may be reported to appropriate organizations, data
banks and governmental bodies. Dr. Rodebaugh acknowledges that his social security number will
be used if this information is so reported and agrees to provide his social security number to the
Board for such purposes.
EFFECTIVE DATE
It is expressly understood that this Consent Agreement is subject to ratification by the Board prior
to signature by the Secretary and Supervi sing Member and shall become effective upon the last date
of signature below.

NCE A. TALMGE>MO
Secretary (J
DATE DATE)
r ;ZD/ D
J

Attorney for Dr. Rodebaugh
DATE DATE
_
Enforcement Attorney
" Jr-z 1....:-1o _
DATE

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