STEPII

CONSENTAGREEMENT
BETWEEN
JOHN KEITH KREBS,M.D.,
AND
THESTATE MEDICALBOARDOF OHIO
This ConsentAgreement isentered into byand between John Keith Krebs, M.D.[Dr.Krebs],
and theState Medical Board ofOhio [Board], astate agencycharged with enforcingChapter
4731., Ohio RevisedCode.
Dr.Krebs enters into this ConsentAgreementbeing fullyinformedofhisrights under Chapter
119.,OhioRevised Code, includingthe righttorepresentation bycounseland therighttoa
formal adjudicativehearingonthe issues considered herein.
BASIS FOR ACTION
This ConsentAgreementisentered intoonthe basisofthe following stipulations,admissions
and understandings:
A. The Board isempoweredbySection 4731.22(B), Ohio Revised Code, tolimit,
revoke, suspend acertificate,refusetoregister orreinstate anapplicant,orreprimand
orplace on probationtheholder ofacertificateforviolationofSection
4731.22(B)(26),Ohio Revised Code, for "impairmentofability topracticeaccording
toacceptableand prevailingstandardsofcare because ofhabitual orexcessiveuseor
abuse ofdrugs, alcohol,orother substances that impairability to practice;"Section
4731.22(B)(J0), Ohio Revised Code, "[c]ommissionof an act that constitutes a felony
inthisstate, regardlessofthejurisdictioninwhich theact wascommitted;"and/or
Section4731.22(B)(12),Ohio Revised Code,"[c]ommissionofanact inthecourse of
practicethat constitutesamisdemeanorinthis state, regardless ofthejurisdictionin
which the act was committed."
B. The Board enters into this ConsentAgreementinlieuofformal proceedingsbased
upon the violationsofSection 4731.22(B)(26), Ohio Revised Code; Section
4731.22(B)(10), Ohio Revised Code, towit: DeceptiontoObtainaDangerousDrug,
Section2925.22,Ohio Revised Code, and IllegalProcessingof Drug Documents,
Section2925.23,Ohio RevisedCode; and Section 4731.22(B)(12),Ohio Revised
Code, towit: Selling,Purchasing,Distributing,orDeliveringDangerousDrugs.
Section4729.51(C)(3), Ohio Revised Code. Theaforementionedviolationsofthe
Medical Practices Act were based upon theallegations setforth intheNotice of
OpportunityforHearingissued on August 12,2009; theadmissions setforth in
Paragraph Eof the Step I Consent Agreement Between John Keith Krebs, M.D., and
STEP IICONSENTAGREEMENT
JOHN KEITH KREBS, M.D.
PAGE 2
theState MedicalBoard ofOhio, effectiveDecember9,2009 [December2009 Step I
ConsentAgreement];and the matters assetforth inParagraphEbelow. TheBoard
expresslyreservesthe right toinstitute formal proceedingsbased upon anyother
violationsofChapter4731. oftheRevised Code, whether occurringbefore orafterthe
effectivedate ofthis ConsentAgreement.
C. Dr.Krebs isseekingreinstatementofhiscertificateto practice medicine andsurgery,
license number35.066400,which was indefinitelysuspended,butnot lessthan 270
days, pursuanttothe December2009 Step IConsentAgreement,acopyofwhich is
attachedhereto and incorporatedherein.
D. Dr.Krebs states that heisnot licensed topracticeinanyotherstateorjurisdiction.
E. Dr.Krebs admits that after enteringresidential treatment forchemicaldependencyon
orabout June 13,2009, attheClevelandClinic Foundation,aBoard-approved
treatmentproviderinCleveland,Ohio, hewasdischarged, treatmentcomplete, onor
about July 11,2009. Dr. Krebs states, andtheBoard acknowledgesreceipt of
informationto support,that since beingdischarged from theClevelandClinic, hehas
remained compliantwith the aftercare contractheentered onor about July 9,2009,as
modifiedonor about December21,2009, includingattendingandparticipatinginat
leastthree 12-step meetingsperweek, attendingat leastone aftercaremeeting per
week, and submittingtorandom drugand alcohol testing. Dr.Krebs admits thatthe
aforementionedaftercarecontractremains ineffect.
Dr.Krebs further admitsthathehasbeendiagnosedwith depression,and thathehas
received treatmentforthis condition. Dr.Krebs states, and theBoard acknowledges
receipt ofinformationtosupport, thatheisincompliancewith hismental health
treatmentplan.
Dr. Krebs states, and theBoard acknowledges,that Gregory B.Collins, M.D., with
theCleveland Clinic, and ChristopherAdelman,M.D., with GlenbeighHospital,a
Board-approvedtreatmentproviderinRockCreek, Ohio, have each provided a
written report indicatingthat Dr.Krebs' ability topracticehas been assessed and that
hehas been found capable ofpracticingaccordingtoacceptableand prevailing
standardsof care, so longascertaintreatmentand monitoringconditionsareinplace.
Dr.Krebs states, and theBoard acknowledges, thatAaron Billowitz,M.D., a
psychiatrist approved by the Board to conduct a psychiatric examinationof Dr. Krebs,
hasprovidedawrittenreport indicating thatDr. Krebs' ability topracticehasbeen
assessed and that he has been found capable ofpracticingaccordingtoacceptableand
prevailingstandardsofcare, solongascertaintreatmentand monitoringconditions
are inplace, includingthatDr. Krebscontinuetomeet with hispsychiatristfor
treatmentatleast once every three months.
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STEP [I CONSENTAGREEMENT
JOHN KEITH KREBS, M.D.
PAGE 3
Accordingly,Dr. Krebsstates,and the Boardacknowledgesreceiptofinformationto
support,thatDr. Krebshas substantiallyfulfilled the conditionsfor reinstatementof
his certificateto practicemedicineand surgeryin the StateofOhio,as established in
the above-referencedDecember2009StepIConsentAgreementbetweenDr. Krebs
and the Board.
AGREED CONDITIONS
Wherefore, inconsiderationofthe foregoingand mutualpromiseshereinafterset forth, and in
lieuof any formal proceedingsat thistime,the certificateofDr. Krebsto practicemedicineand
surgeryin the StateofOhioshallbe REINSTATED,andDr. Krebsknowinglyandvoluntarily
agreeswiththe Boardto the following PROBATIONARYterms,conditionsand limitations:
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1. Dr. Krebsshall obeyall federal, state,and local laws,andall rulesgoverningthe
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2. Dr. Krebs shallsubmitquarterlydeclarationsunderpenaltyofBoarddisciplinary
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actionand/orcriminalprosecution,statingwhethertherehasbeencompliancewithall
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theconditionsof thisConsentAgreement. Thefirst quarterlydeclarationmustbe
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received in the Board'sofficeson the datehis quarterlydeclarationwouldhavebeen
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duepursuantto his December2009StepIConsentAgreementwiththe Board,or as
otherwiserequestedby the Board. Subsequentquarterlydeclarationsmustbe
received in theBoard'sofficeson orbeforethe first dayofeverythirdmonth.
3. Dr. Krebsshallappearin personfor an interviewbeforethe full Boardor its
designatedrepresentative. Thefirst suchappearanceshalltakeplaceon the datehis
appearancewouldhavebeenscheduledpursuantto his December2009StepI
ConsentAgreementwiththe Board. Subsequentpersonalappearancesmustoccur
everythreemonthsthereafter,and/oras otherwiserequestedbythe Board. Ifan
appearance ismissedor isrescheduledfor anyreason,ensuingappearancesshall be
scheduled basedon theappearancedateas originallyscheduled.
4. Dr. Krebsshallobtainpermissionfrom the Boardfor departuresor absencesfrom
Ohio. Suchperiodsof absenceshallnot reducethe probationaryterm, unless
otherwisedeterminedbymotionof the Boardfor absencesof threemonthsor longer,
or by the Secretaryor the SupervisingMemberof the Board for absencesoflessthan
threemonths, in instanceswherethe Boardcanbe assuredthatprobationary
monitoringis otherwisebeingperformed. Further,the SecretaryandSupervising
Memberofthe Boardshallhavethe discretionto granta waiverof partor allofthe
probationarytermsset forth in this ConsentAgreementfor occasionalperiodsof
absenceoffourteendaysor less. Inthe eventthatDr. Krebsresidesand/oris
employedat a locationthatis withinfifty milesofthe geographicborderofOhioand
any ofits contiguousstates,Dr. Krebsmay travel betweenOhioandthatcontiguous
statewithoutseeking priorapproval of the Secretaryor SupervisingMemberprovided
STEP IICONSENTAGREEMENT
JOHN KEITH KREBS, M.D.
PAGE4
that Dr. Krebs is ableto otherwisemaintainfull compliancewithall otherterms,
conditionsandlimitationsset forth inthis ConsentAgreement.
5. In the event Dr. Krebsis found by the Secretaryofthe Boardto havefailed tocomply
withany provisionofthis ConsentAgreement,and isso notifiedof thatdeficiencyin
writing,suchperiod(s)ofnoncompliancewill not applyto the reductionofthe
probationaryperiodunderthisConsentAgreement.
MONITORINGOFREHABILITAnONANDTREATMENT
DrugAssociated Restrictions
6. Dr. Krebs shall keepa log of all controlledsubstancesprescribed. Suchlog shall be
submitted,inthe formatapprovedbythe Board,on the dateuponwhichDr. Krebs'
quarterlydeclarationisdue,or asotherwisedirectedby the Board. Further,Dr. Krebs
shall makehis patientrecordswithregard to suchprescribingavailablefor reviewby
an agentoftheBoardimmediatelyuponrequest.
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7. Dr. Krebsshallnot,withoutpriorBoardapproval,administer,personallyfurnish, or
possess(exceptas allowedunderParagraph8below)any controlledsubstancesas
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defined bystateor federal law. Inthe eventthat the Boardagreesat a futuredateto
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- modifythisConsentAgreementtoallowDr. Krebsto administeror personallyfurnish
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controlledsubstances, Dr .Krebsshall keep a logof all controlledsubstances
cJ prescribed,administered or personallyfurnished. Suchlog shall be submittedin the
formatapprovedby the Boardand shallbe submittedto the Boardno laterthanthe
dateuponwhichDr. Krebs'quarterlydeclarationis due, or as otherwisedirectedby
the Board. Further,Dr. Krebsshall makehis patientrecordswithregardto such
prescribing,administering,or personallyfurnishing availablefor reviewbyan agent
ofthe Boardimmediatelyuponrequest.
Sobriety
8. Dr. Krebsshall abstaincompletelyfrom the personaluse or personal possessionof
drugs,exceptthoseprescribed,dispensedor administeredto himby anotherso
authorized by law who has full knowledgeofDr. Krebs' historyof chemical
dependency. Further,inthe eventthat Dr. Krebs isso prescribed,dispensedor
administeredany controlledsubstance,carisoprodol,or trarnadol, Dr. Krebsshall
notifythe Boardin writingwithinsevendays,providingtheBoardwiththe identityof
the prescriber;the nameofthe drugDr. Krebsreceived; the medicalpurposefor
whichhe receivedsaid drug;the datesuchdrugwas initiallyreceived;and the dosage,
amount, numberofrefills,and directionsfor use. Further,withinthirtydaysofthe
datesaid drugisso prescribed,dispensed,or administeredto him,Dr. Krebsshall
providetheBoardwith eitheracopyofthe written prescriptionor otherwritten
STEP IICONSENTAGREEMENT
JOHNKEITH KREBS, M.D.
PAGE 5
verificationfrom theprescriber, includingthedosage, amount,numberofrefills, and
directions foruse.
9. Dr. Krebs shall abstaincompletelyfrom the useofalcohol.
Drug and Alcohol ScreenslDrug Testing Facility and Collection Site
10. Dr. Krebs shall submittorandom urine screenings fordrugs andalcohol at leasttwo
times per month,orasotherwisedirectedbythe Board. Dr. Krebs shall ensurethat
all screeningreportsare forwarded directlytotheBoard on aquarterlybasis. The
drug testingpanel utilizedmust beacceptabletothe Secretaryofthe Board, and shall
include Dr.Krebs' drug(s)ofchoice.
Dr.Krebs shall abstainfrom the useof anysubstanceand theconsumptionof poppy
seeds oranyotherfoodor liquid that mayproducealow level positiveresult ina
toxicologyscreen. Dr.Krebs acknowledgesthat heunderstandsthat theconsumption
or useofsuchsubstances, includingbut notlimitedtosubstancessuch asmouthwash
orhand cleaninggel, maycause apositivedrug screenthatmay not beable tobe
differentiatedfrom intentional ingestion,and thereforesuch consumptionor useis
( prohibitedunderthis ConsentAgreement.
Allsuch urine screeningsfordrugs andalcohol shall beconductedthroughaBoard-
0 . approveddrug testingfacility andcollectionsite pursuanttothe global contract
betweensaid facility and the Board,that provides fortheBoard to maintainultimate
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control overthe urine screeningprocessand topreservetheconfidentialityofall
positivescreeningresults inaccordancewith Section4731.22(F)(5),Ohio Revised
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Code, and the screeningprocessshall require adaily call-inprocedure. Further, inthe
eventthat the Board exercises itsdiscretion,asprovided inParagraph 11 below,to
approve urine screeningstobeconducted atanalternativedrug testing facility and/or
collectionsite orasupervisingphysician,such approval shall beexpresslycontingent
upon the Board retainingultimatecontrol over the urine screeningprocessina
mannerthat preservesthe aforementionedconfidentialityofallpositivescreening
results.
Dr.Krebs shall submit,athis expenseandon thedayselected, urine specimensfor
drug and/oralcoholanalysis. All specimenssubmitted byDr. Krebs shall benegative,
exceptforthose substancesprescribed,administered,ordispensedtohim in
conformancewith the terms, conditionsand limitationsset forth inthis Consent
Agreement. Refusal tosubmitsuch specimen,or failure tosubmitsuch specimenon
theday he isselectedor insuch manneras theBoard may request, shall constitutea
violationofthis ConsentAgreement.
Further,withinthirty days oftheeffectivedate ofthis ConsentAgreement,Dr.Krebs
shall enterinto the necessaryfinancial and/orcontractual arrangementswith the
STEP IICONSENTAGREEMENT
JOHN KEITH KREBS, M.D.
PAGE6
Board-approveddrug testing facility and/or collectionsite inordertofacilitate the
urine screeningprocess inthe manner required bythis ConsentAgreement. Further,
Dr.Krebs shall promptlyprovidetothe Board written documentationofcompletion
ofsuch arrangements, includingacopyofanycontractentered into between Dr.
Krebs and the Board-approveddrug testing facility and/orcollectionsite. Dr.Krebs'
failure totimely completesuch arrangements,orfailure totimely providewritten
documentationto the Boardofcompletionofsuch arrangements,shall constitutea
violationofthis ConsentAgreement. However, Dr. Krebs andthe Board further
agree that inthe event Dr.Krebspreviouslyentered into the aforementionedfinancial
and contractualagreementspursuanttotherequirementsofaprior consentagreement
with the Board under whichDr.Krebs iscurrently participatinginan ongoing urine
screeningprocess,then this requirementshaIlbewaived under the instant consent
agreement.
Dr.Krebs shall ensurethat theurinescreeningprocessperformedthrough theBoard-
approved drug testingfacility and/or collectionsite requires adaily call-in procedure;
thatthe urine specimensareobtained onarandombasis; andthat thegiving ofthe
specimeniswitnessedbyareliableperson. Inaddition, Dr.Krebs and theBoard-
approveddrug testingfacility and collectionsiteshall assure thatappropriatecontrol
over thespecimenismaintainedandshall immediatelyinform the Boardofany
n positivescreeningresults.
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Dr.Krebs shall ensure thatthe Board-approveddrugtestingfacility and/orcollection
site providesquarterlyreports totheBoard, inaformat acceptabletothe Board,
verifying whetherall urine screenshave beenconducted incompliancewiththis
ConsentAgreement,and whetherall urinescreenshave beennegative.
Intheeventthat the Board-approveddrug testing facility and/or collectionsite
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becomesunable orunwillingtoserveasrequired bythis ConsentAgreement,Dr.
Krebs mustimmediatelynotify theBoard inwriting, and make arrangements
acceptableto the Board pursuanttoParagraph II below, assoon aspracticable. Dr.
Krebs shall further ensure that theBoard-approveddrug testing facility and/or
collectionsite also notifies the Boarddirectly ofitsinabilitytocontinuetoserveand
thereasons therefore.
Dr.Krebs acknowledgesthat the Boardexpresslyreserves theright towithdrawits
approval ofany drug testing facility and/or collectionsite inthe event that the
Secretaryand SupervisingMemberofthe Boarddeterminethatthe drug testing
facility and/orcollectionsitehasdemonstratedalackofcooperation inproviding
informationto the Board orforanyother reason.
II. Dr.Krebs and the Board agree that itisthe intent ofthis ConsentAgreementthatDr.
Krebs shall submithis urine specimenstothe Board-approveddrug testing facility
andcollectionsite chosenbythe Board. However, inthe event that utilizing said
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STEP IICONSENTAGREEMENT
JOHN KEITH KREBS, M.D.
PAGE 7
Board-approveddrug testing facilityand/orcollectionsitecreatesanextraordinary
hardshipupon Dr.Krebs, asdeterminedinthesole discretionofthe Board, then
subjectto the following requirements,theBoard mayapproveanalternatedrug
testing facility and/orcollectionsite, orasupervisingphysician,tofacilitate theurine
screening processfor Dr.Krebs:
a. Within thirtydays ofthedate uponwhichDr.Krebs isnotifiedoftheBoard's
determinationthat utilizingtheBoard-approveddrug testing facility and/or
collectionsiteconstitutesanextraordinaryhardshipupon Dr.Krebs, heshall
submittothe Board inwritingforitsprior approval theidentity ofeitheran
alternatedrug testingfacilityandcollectionsite, orthename ofaproposed
supervisingphysician,towhom Dr.Krebs shall submitthe required urine
specimens. Inapprovingafacility,entity, oranindividual toserve inthis
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capacity,the Board willgivepreferencetoafacility located near Dr.Krebs'
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residenceoremploymentlocation, ortoaphysicianwho practicesinthesame
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localeas Dr.Krebs. Dr.Krebs shallensure that theurine screeningprocess
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performed through thealternatedrug testing facility and/orcollectionsite,or
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through the supervisingphysician, requires adailycall-in procedure;thatthe
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urine specimensareobtained onarandom basis; and that thegivingofthe
specimeniswitnessedbyareliable person. Inaddition,Dr.Krebs
acknowledgesthat the alternate drug testing facility andcollectionsite,orthe
supervisingphysician,shallassure thatappropriatecontrol over thespecimen is
maintainedand shall immediatelyinform theBoard ofanypositivescreening
results.
b. Dr. Krebs shall ensure thatthealternate drug testing facility and/orcollection
site, or thesupervisingphysician, providesquarterly reports totheBoard, ina
formatacceptabletotheBoard, verifying whetherall urine screens have been
conductedincompliancewith thisConsentAgreement,and whetherallurine
screenshave been negative.
c. Inthe eventthat thedesignatedalternate drug testingfacility and/or collection
site, orthesupervisingphysician,becomes unable orunwillingtososerve,Dr.
Krebs must immediatelynotify theBoard inwriting. Dr.Krebs shall further
ensurethat the previouslydesignatedalternatedrug testing facility and
collectionsite, or thesupervisingphysician, also notifiestheBoard directlyof
the inabilitytocontinuetoserveand thereasons therefore. Further, inorder to
ensure that there will be nointerruptioninhis urine screeningprocess, upon the
previouslyapprovedalternatedrug testing facility, collectionsite,or supervising
physicianbecomingunable toserve,Dr.Krebs shall immediatelycommence
urine screeningattheBoard-approveddrug testing facility and collectionsite
chosen bytheBoard, until such time,ifany,thattheBoard approvesa
subsequentalternatedrug testing facility, collectionsite,orsupervising
physician,ifrequestedbyDr.Krebs.
STEP IICONSENTAGREEMENT
JOHN KEITH KREBS, M.D.
PAGE 8
d. The Board expresslyreservestheright todisapproveanyentity orfacility
proposedto serve asDr. Krebs' designatedalternatedrug testing facilityand/or
collectionsite, oranyperson proposedtoserve ashis supervisingphysician, or
towithdrawapproval ofanyentity, facilityorperson previouslyapprovedtoso
serve intheeventthat theSecretaryand SupervisingMemberofthe Board
determinethat anysuchentity,facility orperson hasdemonstratedalackof
cooperationinprovidinginformationtothe Board orforanyother reason.
12. All screeningreportsrequired underthis ConsentAgreementfrom the Board-
approveddrug testing facility and/orcollectionsite, orfrom the alternatedrugtesting
facility and/orcollectionsite orsupervisingphysician, must bereceived inthe
Board'sofficesno laterthan the duedate forDr.Krebs' quarterlydeclaration. It is
Dr. Krebs' responsibilitytoensure that reports aretimely submitted.
13. The Board retains theright torequire, and Dr.Krebs agrees tosubmit,blood,urine,
breath, saliva and/orhair specimensforscreeningfordrugs andalcohol, foranalysis
of therapeuticlevels of medicationsthat may beprescribed forDr. Krebs,orforany
other purpose,atDr. Krebs' expenseuponthe Board'srequestand withoutprior
notice. Dr.Krebs' refusal tosubmitaspecimenupon requestoftheBoard shall result
in a minimumof one yearof actual license suspension. Further, the collectionof such
specimensshall bewitnessed byarepresentativeofthe Board, oranotherperson
acceptableto the SecretaryorSupervisingMember ofthe Board.
Psychiatric Treatment
Within thirtydays oftheeffectivedateofthis Consent Agreement, Dr.Krebs shall
submittothe Board foritspriorapproval the nameand qualificationsofapsychiatrist
ofhischoice. Upon approval bytheBoard, Dr.Krebs shall undergo and continue
psychiatrictreatmentat leastonceeverythree months, orasotherwisedirected bythe
Board. Dr. Krebs shall complywithhispsychiatrictreatmentplan, includingtaking
medicationsasprescribedand/orordered. Dr.Krebs shall ensurethat psychiatric
reports areforwarded byhistreating psychiatristtothe Boardonaquarterly basis,or
asotherwisedirected bythe Board. Thepsychiatricreports shall contain information
describingDr. Krebs' current treatmentplan andanychangesthat have beenmadeto
the treatmentplan since theprior report; Dr. Krebs' compliancewithhistreatment
plan; Dr. Krebs' mental status; Dr.Krebs' progress intreatment;and resultsofany
laboratorystudiesthat have beenconductedsince theprior report. Dr. Krebsshall
ensure that histreatingpsychiatristimmediatelynotifies the Board ofhisfailureto
complywith hispsychiatrictreatmentplanand/or anydeterminationthat Dr.Krebs is
unable topracticedue to hispsychiatricdisorder. 11 isDr. Krebs' responsibilityto
ensurethatquarterlyreports arereceived inthe Board'sofficesno laterthan thedue
date forDr. Krebs' quarterlydeclaration.
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STEP IICONSENTAGREEMENT
JOHNKEITHKREBS, M.D.
PAGE 9
Inthe event thatthe designatedtreating psychiatristbecomesunable orunwillingto
serve inthis capacity,Dr.Krebs must immediatelyso notify theBoard inwriting. In
addition,Dr. Krebs shall make arrangementsacceptabletothe Board foranother
treating psychiatristwithin thirtydaysafter thepreviouslydesignatedtreating
psychiatristbecomesunable orunwillingtoserve, unless otherwisedetermined bythe
Board. Furthermore,Dr.Krebs shallensure that thepreviouslydesignatedtreating
psychiatristalso notifiesthe Boarddirectly ofhisorher inability tocontinuetoserve
and thereasonstherefore.
The Board expresslyreservesthe righttodisapproveanypsychiatristproposed to
serve asDr. Krebs' designated treating psychiatrist,orto withdrawapproval of any
psychiatristpreviouslyapproved toserveasDr.Krebs' designatedtreating
psychiatrist, inthe event thattheSecretary and SupervisingMemberoftheBoard
determinethat any such psychiatristhasdemonstratedalackof cooperationin
providinginformationtothe Boardor foranyother reason.
Monitoring Physician
15. Before engaginginanymedical practice,Dr.Krebs shall submittothe Board in
writing the name and curriculumvitaeof amonitoringphysicianforprior written
approval bythe Secretaryor SupervisingMemberoftheBoard. Inapproving an
individualto serve inthiscapacity,theSecretaryand SupervisingMemberwillgive
preferencetoaphysicianwhopracticesinthe same localeas Dr.Krebs andwhois
engaged inthesame orsimilarpractice specialty.
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The monitoringphysicianshall monitorDr. Krebs andhismedical practice,andshall
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review Dr. Krebs' patientcharts. Thechart review may bedone on arandom basis,
with the frequency and numberof charts reviewed to be determined by the Board.
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monitoringofDr.Krebs and hismedicalpractice,and on thereview ofDr.Krebs'
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patient charts. Dr. Krebs shall ensure thatthereports are forwarded tothe Boardona
quarterlybasis and arereceived inthe Board'sofficesnolater than theduedate for
Dr. Krebs' quarterlydeclaration.
In theevent that the designatedmonitoringphysicianbecomes unableorunwilling to
serve inthis capacity,Dr. Krebsmust immediatelysonotify the Board inwriting. In
addition,Dr. Krebs shall make arrangementsacceptabletothe Board foranother
monitoringphysicianwithin thirtydaysafterthe previouslydesignated monitoring
physicianbecomesunableorunwillingtoserve, unless otherwisedeterminedbythe
Board. Furthermore,Dr. Krebs shallensurethatthepreviouslydesignatedmonitoring
physicianalso notifiesthe Boarddirectly ofhisorher inability tocontinuetoserve
andthe reasons therefore.
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STEP IICONSENTAGREEMENT
JOHN KEITH KREBS, M.D.
PAGE 10
The Board expresslyreserves therighttodisapproveanyperson proposedto
serve asDr.Krebs' designated monitoringphysician,ortowithdrawapproval of
anyperson previouslyapproved toserveasDr.Krebs' designatedmonitoring
physician,intheevent that theSecretaryand SupervisingMemberofthe Board
determinethat anysuch monitoringphysicianhasdemonstrateda lackof
cooperationinprovidinginformationtothe Boardor foranyother reason.
RehabilitationProgram
16. Dr.Krebs shall maintainparticipationinanalcohol anddrug rehabilitationprogram,
such as A.A., N.A.,C.A., orCaduceus, nolessthan three times per week.
Substitutionof any otherspecific program must receive priorBoardapproval.
Dr.Krebs shall submitacceptabledocumentaryevidenceofcontinuingcompliance
with this program, includingsubmissiontothe Boardofmeetingattendancelogs,
which must bereceivedinthe Board'soffices no later than the duedate forDr.
Krebs' quarterlydeclarations.
Aftercare
17. Dr.Krebs shall contactanappropriateimpaired physicianscommittee,approvedby
the Board, toarrange forassistanceinrecovery oraftercare.
18. Dr.Krebs shall maintaincontinuedcompliancewith theterms oftheaftercare
contractentered into with aBoard-approvedtreatmentprovider,providedthat,where
terms oftheaftercarecontractconflictwithterms ofthis ConsentAgreement,the
terms ofthis ConsentAgreementshallcontrol.
Releases
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19. Dr.Krebs shall provideauthorization,through appropriatewrittenconsentforms,for
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- disclosureofevaluativereports, summaries,and records, ofwhatevernature, byany
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and allpartiesthat providetreatmentorevaluationforDr.Krebs' chemical
dependency,psychiatricconditions,orrelated conditions,orforpurposes of
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complyingwith this ConsentAgreement, whethersuch treatmentorevaluation
occurredbefore orafter theeffectivedateofthisConsentAgreement. Totheextent
permittedbylaw, theabove-mentionedevaluativereports, summaries,and records are
consideredmedical records forpurposesofSection 149.43ofthe Ohio Revised Code
and areconfidentialpursuanttostatute. Dr.Krebs further agrees toprovidetheBoard
writtenconsentpermittinganytreatmentproviderfrom whom heobtains treatment to
notify the Board inthe event hefailstoagree toorcomplywith anytreatmentcontract
oraftercarecontract. Failure toprovidesuchconsent,orrevocationofsuchconsent,
shallconstituteaviolationofthisConsentAgreement.
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STEP IICONSENTAGREEMENT
JOHN KEITH KREBS, M.D.
PAGE II
RequiredReportingby Licensee
20. Withinthirty days ofthe effectivedate ofthis ConsentAgreement, Dr. Krebsshall
provideacopyofthisConsentAgreementto allemployersorentitieswithwhichhe
is undercontractto providehealthcare services(includingbut not limitedto third
partypayors)or isreceivingtraining,and the ChiefofStaffateachhospital wherehe
has privilegesor appointments. Further, Dr. Krebsshallpromptlyprovideacopy of
this ConsentAgreementto allemployersor entitieswithwhichhecontractsto
providehealthcareservices,or appliesfor orreceives training,and the ChiefofStaff
ateachhospital wherehe appliesforor obtainsprivilegesor appointments. Inthe
eventthat Dr. Krebsprovidesany healthcare servicesor healthcaredirectionor
medicaloversightto any emergencymedical servicesorganizationor emergency
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medical servicesprovider, withinthirtydays ofthe effectivedateofthis Consent
Agreement Dr. Krebsshall provideacopy ofthis ConsentAgreementtothe Ohio
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DepartmentofPublic Safety,DivisionofEmergencyMedical Services. Further, Dr.
Krebsshallprovidethe Boardwith one ofthe followingdocumentsasproof of each
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required notificationwithinthirtydays ofthe date of eachsuchnotification: (1) the
returnreceiptofcertifiedmail withinthirtydays ofreceivingthat returnreceipt, (2)an
acknowledgementofdelivery bearingthe original ink signatureofthe personto
whomacopyofthe ConsentAgreementwas hand delivered,(3) the original
facsimile-generatedreportconfirmingsuccessful transmissionof acopyof the
ConsentAgreementto the personor entityto whomacopyofthe ConsentAgreement
was faxed,or (4) an originalcomputer-generatedprintoutof electronicmail
communicationdocumentingthe emailtransmissionofacopyofthe Consent
Agreementto the personor entitytowhomacopyofthe ConsentAgreementwas
emailed.
21. Withinthirtydays ofthe effectivedate of thisConsentAgreement, Dr.Krebsshall
provideacopyofthisConsentAgreementto the properlicensingauthorityof any
stateorjurisdictionin whichhe currentlyholdsany professional license,as well as
any federal agency orentity, includingbut not limitedto the DrugEnforcement
Agency,throughwhichhe currentlyholdsany licenseor certificate. Dr. Krebsfurther
agreesto provideacopyofthis ConsentAgreementat timeof applicationtothe
properlicensingauthorityofany stateinwhichhe appliesfor any professional license
or for reinstatementof any professional license. Further, Dr. Krebsshallprovidethe
Board withoneofthe following documentsas proofofeachrequired notification
withinthirtydays ofthe dateof eachsuchnotification: (1) the returnreceiptof
certifiedmail withinthirtydays ofreceivingthatreturnreceipt, (2) an
acknowledgementof delivery bearingthe original ink signatureofthe personto
whomacopyofthe ConsentAgreementwas handdelivered,(3) the original
facsimile-generatedreportconfirmingsuccessfultransmissionof acopyofthe
ConsentAgreementto the personorentitytowhomacopyofthe ConsentAgreement
was faxed, or (4) an original computer-generatedprintoutofelectronicmail
STEP IICONSENTAGREEMENT
JOHNKErTH KREBS, M.D.
PAGE 12
communicationdocumentingtheemail transmissionofacopy ofthe Consent
Agreementtothe personorentity towhom acopy ofthe ConsentAgreementwas
emailed.
22. Dr.Krebs shall promptlyprovide acopy ofthis ConsentAgreementtoallpersonsand
entitiesthat provideDr. Krebs treatmentor monitoringforhis chemical dependency,
mental healthorany related conditions. Further,Dr. Krebs shalJprovidetheBoard
with one ofthe followingdocumentsasproofofeach requirednotificationwithin
thirty days ofthedate ofeach such notification: (1) the returnreceipt ofcertifiedmail
. ' (
withinthirty days ofreceivingthat return receipt, (2)anacknowledgementofdelivery
bearingtheoriginal inksignatureofthepersontowhom acopy oftheConsent
Agreementwas hand delivered,(3)theoriginal facsimile-generated report confirming
., .
successfultransmissionofacopyoftheConsentAgreementtothe personorentity to
whomacopy ofthe ConsentAgreementwas faxed, or(4) anoriginal computer-
'-
generatedprintoutofelectronicmail communicationdocumentingtheemail
transmission ofacopy oftheConsentAgreementtothe personorentity towhom a
copyofthe ConsentAgreementwasemailed.
23. Dr. Krebs shall notify the Board inwritingofanychange ofprincipal practice address
orresidenceaddresswithin thirty daysofsuch change.
FAILURE TO COMPLY
If, in the discretionof the Secretary and Supervising Memberof the Board, Dr. Krebs appears to
have violatedor breachedany term orconditionofthis ConsentAgreement,theBoard reserves
theright to instituteformal disciplinaryproceedingsforanyandallpossibleviolationsor
breaches, including,but not limited to,alleged violationsof the lawsof Ohio occurringbefore
theeffectivedate ofthis ConsentAgreement.
IftheSecretaryand SupervisingMemberoftheBoard determinethat there isclear and
convincingevidencethat Dr. Krebs has violatedanyterm, conditionorlimitationofthis Consent
Agreement,Dr.Krebs agrees that the violation,asalleged,also constitutesclear and convincing
evidencethat his continuedpracticepresentsadangerofimmediateand seriousharm tothe
public forpurposesofinitiatingasummarysuspensionpursuanttoSection4731.22(0),Ohio
Revised Code.
DURATIONIMODIFICATION OF TERMS
Dr. Krebs shall not requestterminationofthis ConsentAgreementforaminimumoffiveyears.
Inaddition, Dr. Krebs shall not requestmodificationtotheprobationaryterms, limitations,and
conditionscontainedherein forat least one year,exceptthat Dr. Krebs may make such request
with themutual approvalandjointrecommendationofthe Secretary and SupervisingMember.
Otherwise,theabove-describedterms, limitationsand conditionsmay beamendedorterminated
inwriting atany time upontheagreementofboth parties.
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STEP II CONSENT AGREEMENT
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JOHN KEITH KREBS, M.D.
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PAGE 13
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In the event that the Board initiates future formal proceedings against Dr. Krebs, 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. Krebs and the Board agree that
all other terms, limitations, and conditions contained in this Consent Agreement shall be
unaffected.
ACKNOWLEDGMENTSILIABILITY RELEASE
Dr. Krebs 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. Krebs 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. Krebs 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 signature below.
\KJ aM-a. Ct..
I\ NCE A. TALMA
Secretary
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DATE
DATE
STEP II CONSENT AGREEMENT
JOHN KEITH KREBS,M.D.
PAGE 14
ERICJ.PLINKE JACKC. AMATO,M.D.
AttorneyforDr. Krebs ActingSupervisingMember
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DATE
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MARK R. BLACKMER
EnforcementAttorney
DATE
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