Williams v. Minn. Bd. of Nursing
| Decision Date | 10 May 2021 |
| Docket Number | A20-0969 |
| Parties | Tonia N. Williams, Relator, v. Minnesota Board of Nursing, Respondent. |
| Court | Minnesota Court of Appeals |
This opinion is nonprecedential except as provided by Minn. R. Civ. App. P. 136.01, subd. 1(c).
Affirmed
Minnesota Board of Nursing
Tonia N. Williams, Brooklyn Park, Minnesota (self-represented relator)
Keith Ellison, Attorney General, Alex Mountain, Nicholas Lienesch, Assistant Attorneys General, St. Paul, Minnesota (for respondent)
Considered and decided by Gaïtas, Presiding Judge; Larkin, Judge; and Cochran, Judge.
NONPRECEDENTIAL OPINION
In this certiorari appeal, relator Tonia N. Williams challenges a decision by respondent Minnesota Board of Nursing rescinding a stipulation and consent order and indefinitely suspending Williams's licenses to practice professional and practical nursing. Williams argues that (1) the board's decision is not supported by substantial evidence, (2) the board's procedure violated her due-process rights, and (3) the suspension of her licenses violates her right to equal protection under the law. We affirm.
For many years, Williams held licenses from the board to practice professional and practical nursing. In 2018, following Williams's convictions for three separate gross misdemeanor driving offenses involving alcohol and controlled substances, the board pursued disciplinary action against her. In February 2019, Williams and the board entered into a stipulation and consent order (consent order) that resolved the disciplinary action. In the consent order, signed by both parties, Williams acknowledged that her convictions subjected her to board discipline because the criminal conduct was reasonably related to the practice of nursing. Minn. Stat. § 148.261, subd. 1(3) (2020). She also agreed that her conduct demonstrated "actual or potential inability to practice nursing with reasonable skill and safety to patients by reason of illness, use of alcohol, drugs, chemicals, or any other material, or as a result of any mental or physical condition." Id., subd. 1(9) (2020).
The consent order suspended Williams's nursing licenses but stayed the suspension and allowed Williams to continue practicing nursing so long as she complied with certain conditions. The conditions included that Williams participate in the Health Professionals Services Program (HPSP), a statutorily authorized monitoring agency, see Minn. Stat. § 214.31 (2020), and "successfully complete all terms of her HPSP Participation Agreement." It also required her to abstain from mood-altering substances, among other conditions. The parties agreed in the consent order that if Williams violated the conditionsof the stay, the board's review panel1 could, upon probable cause, order removal of the stayed suspension and schedule a hearing before the board for a final determination. As to the hearing, the parties specifically agreed:
Prior to the hearing before the Board, the Review Panel and [Williams] may submit affidavits and written argument in support of their positions. At the hearing, the Review Panel and [Williams] may present oral argument. Argument will not refer to matters outside the record. The evidentiary record will be limited to the affidavits submitted prior to the hearing and this Stipulation and Consent Order. Unless stated otherwise in this Stipulation and Consent Order,[2] the Review Panel will have the burden of proving by a preponderance of the evidence that a violation has occurred. . . . [Williams] waives a hearing before an administrative law judge, discovery, cross-examination of adverse witnesses, and other procedures governing hearings pursuant to Minnesota Statutes chapter 14.
About five months after the parties entered the consent order, the review panel issued an order removing the stayed suspension, thereby suspending Williams's nursing licenses. In the order of removal, the review panel asserted that Williams had not complied with the terms of her HPSP participation agreement, specifically citing problematic toxicology screens, an arrest for felony DWI-test refusal in March 2019, failure to submit worksite monitor reports, and termination from employment. Williams met with thereview panel shortly thereafter, and, following the meeting, the board rescinded the order that removed the stayed suspension. The board reinstated the consent order, again providing Williams the chance to maintain her licensure so long as she complied with its terms, including monitoring by the HPSP.
Thereafter, from September 2019 to January 2020, the HPSP filed multiple reports with the board. The reports relayed that Williams had missed toxicology screenings on a few occasions, tested positive for opiates,3 and had another screening test positive for amphetamine, methamphetamine, and cannabis. In February 2020, the HPSP obtained an expert opinion from a toxicologist regarding the screening that tested positive for amphetamine, methamphetamine, and cannabis. Although Williams had a prescription for medical cannabis, the toxicologist relayed that none of her prescribed medications contained amphetamine or methamphetamine. He opined that a positive toxicology screen could only have resulted from ingestion or exposure to amphetamine and methamphetamine. A few days after the toxicologist provided his opinion, the HPSP reported to the board that Williams had been unsatisfactorily discharged from the program due to positive toxicology screening.
In April 2020, the review panel served Williams with a new order of removal of stay of suspension, again suspending her licenses, and also served her with a notice of suspension and of a hearing. The review panel alleged three grounds for discipline: (1) Williams failed to comply with the terms of her HPSP participation agreement inviolation of the terms of the consent order and Minnesota Statutes section 148.261, subdivision 1(18) (); (2) Williams failed to abstain from all mood-altering substances in violation of the terms of the consent order and Minnesota Statutes section 148.261, subdivision 1(18); and (3) Williams was unsatisfactorily discharged from the HPSP pursuant to Minnesota Statutes section 214.355 (2020). To support its allegations, the review panel submitted an affidavit of the HPSP case manager assigned to Williams, with attached exhibits that included Williams's signed HPSP participation agreement, reports detailing Williams's missed toxicology screens, toxicology screening reports, and the letter from the toxicologist regarding the screen that was positive for amphetamine and methamphetamine.
Prior to the hearing, Williams submitted a response to the review panel's allegations and several of her own exhibits, including laboratory results indicating a negative April 10, 2019 Phosphatidylothanol (PEth) test, her prescription profile, information on medical marijuana, and a May 2020 chemical-use assessment.
In June 2020, the board held a hearing and heard arguments from Williams and the review panel. Williams asserted that she did not consume alcohol or use drugs other than those prescribed to her, that the HPSP had been difficult to work with, and that the positive toxicology screen must have been a "mix-up."
After the hearing, the board issued findings of fact, conclusions, and a final order that suspended Williams's licenses indefinitely. The board concluded that the preponderance of the evidence showed that Williams violated the terms of the consent order, and thereby violated Minnesota Statutes section 148.261, subdivision 1(18). Thefinal order suspends Williams's licenses to practice practical and professional nursing for a minimum of twelve months, at which time she may petition for reinstatement.
Williams appeals.
Appellate courts will reverse agency decisions "only when they reflect an error of law, the findings are arbitrary and capricious, or the findings are unsupported by substantial evidence." Cable Commc'ns Bd. v. Nor-W. Cable Commc'ns P'ship, 356 N.W.2d 658, 668 (Minn. 1984). Ordinarily, agency decisions receive a presumption of correctness, and appellate courts defer to the agency's expertise and special knowledge in its field. In re Annandale NPDES/SDS Permit Issuance, 731 N.W.2d 502, 514 (Minn. 2007); N. States Power Co. v. Minn. Pub. Utils. Comm'n, 344 N.W.2d 374, 377 (Minn. 1984). "The relator has the burden of proof when challenging an agency decision . . . ." Minn. Ctr. for Envtl. Advocacy v. Minn. Pollution Control Agency, 660 N.W.2d 427, 433 (Minn. 2003).
The agency in this matter, the Board of Nursing, is authorized under the Minnesota Nurse Practice Act to license and regulate advanced practice registered nurses, registered nurses, and licensed practical nurses, and to take disciplinary action as appropriate. Minn. Stat. §§ 148.171-.285 (2020). The standard of proof for professional licensing proceedings is proof by a preponderance of the evidence. In re License of Friedenson, 574 N.W.2d 463, 466 (Minn. App. 1998), review denied (Minn. Apr. 30, 1998).
Williams argues that we should reverse the board's order suspending her licenses indefinitely for several reasons. She argues that the board's decision was not supported by substantial evidence, and she also asserts two constitutional challenges—that the board'sprocedure violated her substantive due-process rights and that the suspension of her licenses violates equal protection.4 We address each argument in turn.
Williams first argues that the board's decision to indefinitely suspend her licenses was not supported by substantial evidence.
"The substantial-evidence standard addresses the reasonableness of what the agency did on the basis of the evidence before it." In re Expulsion of A.D., 883 N.W.2d 251, 259 (Minn. 2016) (quotation omitted). Substantial evidence is "such relevant...
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