STEPI

CONSENTAGREEMENT
BETWEEN
SHANER.HANZLIK,M.D.,
AND
THESTATEMEDICALBOARDOFOHIO
ThisConsentAgreementisenteredintobyandbetweenShaneR.Hanzlik,M.D.,[Dr.Hanzlik],and
theStateMedicalBoardof Ohio [Board],astateagencychargedwithenforcingChapter4731.,
OhioRevisedCode.
Dr. HanzlikentersintothisConsentAgreementbeingfullyinfonnedof hisrightsunderChapter
119.,OhioRevisedCode,includingtherighttorepresentationbycounselandtherightto afonnal
adjudicativehearingontheissuesconsideredherein.
BASISFORACTION
ThisConsentAgreementisenteredintoonthebasisofthefollowingstipulations,admissionsand
understandings:
A. TheBoardisempoweredbySection4731.22(B).OhioRevisedCode,tolimit,revoke,
suspendacertificate,refusetoregisterorreinstateanapplicant,orreprimandorplaceon
probationtheholderof acertificateforviolationof Section4731.22(B)( I0),Ohio
RevisedCode,for"[c]ommissionofanactthatconstitutesafelonyinthisstate,
a
o
regardlessof thejurisdictioninwhichtheactwascommitted,"and/orSection
-
"
4731.22(B)(26),OhioRevisedCode,for "impairmentof abilitytopracticeaccordingto
acceptableandprevailingstandardsof carebecauseofhabitualorexcessiveuseorabuse
N
ofdrugs,alcohol,orothersubstancesthatimpairabilitytopractice."
-J
_.' B. TheBoardentersintothisConsentAgreementinlieuofformal proceedingsbasedupon
-,
theviolationof Sections 4731.22(B)( 10),towit:DeceptiontoObtainaDangerousDrug,
......'
c'i
-
Section2925.22,OhioRevisedCode;and/or4731.22(BX26),OhioRevisedCode,asset
forthinParagraphEbelow,andexpresslyreservestherighttoinstitutefonnal
proceedingsbaseduponanyotherviolationsofChapter4731.of theRevisedCode,
whetheroccurringbeforeoraftertheeffectivedateof thisAgreement .
C. Dr.HanzlikholdsatrainingcertificateintheStateof Ohio,Licensenumber57.015402.
D. Dr.Hanzlikstatesthatheisnotlicensedtotrainortopracticemedicineinanyotherstate
orjurisdiction.
E. Dr. Hanzlikadmitsthathehasconsumedalcohol,sometimesexcessively,forafew
years. Dr. Hanzlikfurtheradmitsthat,inoraroundJune20II,heconsumedan
STEP ICONSENTAGREEMENT
SHANER. HANZLIK, M.D.
PAGE2
excessiveamountofalcohol. Dr. Hanzlikalso admitsthat, whileundertheinfluenceof
alcohol,hetookapproximatelytwentyPercocettabletsthathad beenprescribedfor a
family member. Dr. Hanzlikstatesthat, to coverup hisactions, he wrote aprescription
for Percocetinthenameofthefamily member, usingthe D.E.A. registrationnumber
assignedto his residencyprogramand signingthe nameofanotherphysicianwithout
thatphysician'sknowledge.
Dr. Hanzlikalso admitsthattheabovedescribedactwasnotthefirsttimehe has written
afalse prescription. Dr. Hanzlikadmitsthathepreviouslywrotethreeprescriptionsfor
testosterone, intendingto usethetestosteronehimself,signingthenameofanother
physicianand usingtheD.E.A. numberoftheresidencyprogram. Dr. Hanzlikstatesthat
he wrotetheprescriptionsfortestosteronetotreataself-determinedmedicalconditionof
lowtestosterone.
Dr. Hanzlikadmitsthatheis impaired inhisabilityto practiceandthathe hasentered
t r e t m e ~ t forchemicaldependencyatGlenbeighHospitalofRockCreek,Ohio
[Glenbeigh],a Board approved treatmentprovider,onoraboutJune 13,2011. Dr.
Hanzlikalso admitsthathe received adiagnosisofchemical dependencyat Glenbeigh
and furtherstatesthatcurrentlyhe is pursuingatleasttwenty-eightdaysofinpatient
treatment.
AGREED CONDITIONS
Wherefore, inconsiderationoftheforegoingand mutual promiseshereinaftersetforth, and in lieu
ofanyformal proceedingsatthis time, Dr. Hanzlikknowinglyand voluntarilyagrees withtheBoard
to thefollowingterms, conditionsand limitations:
SUSPENSION OF CERTIFICATE
I. ThetrainingcertificateofDr. Hanzlikin the StateofOhioshallbeSUSPENDEDforan
indefini'teperiodoftime, butnot lessthan 180days.
Obeyall Laws
2. Dr. Hanzlikshallobeyall federal, state, and local laws.
Sobriety
3. Dr. Hanzlikshallabstaincompletelyfrom thepersonal use orpersonalpossessionof
drugs, exceptthoseprescribed,dispensed oradministeredto him by anotherso
authorized by lawwhohasfull knowledgeofDr. Hanzlik'shistoryofchemical
dependency. FUliher, intheeventthatDr. Hanzlikis soprescribed,dispensed or
administeredanycontrolledsubstance,carisoprodol,ortramadol, Dr. Hanzlikshall
STEP ICONSENTAGREEMENT
SHANER. HANZLIK, M.D.
PAGE3
notifytheBoardinwritingwithinsevendays,providingtheBoardwiththeidentityof
theprescriber;thenameofthedrugDr.Hanzlikreceived;themedicalpurposeforwhich
hereceivedsaiddrug;thedatesuchdrugwasinitiallyreceived; andthedosage,amount,
numberofrefills,anddirectionsforuse. Further,withinthirty daysofthedatesaiddrug
issoprescribed,dispensed,oradministeredtohim,Dr.HanzlikshallprovidetheBoard
witheitheracopyofthewrittenprescriptionorotherwrittenverificationfrom the
prescriber,includingthedosage,amount,numberofrefills,anddirectionsforuse.
4. Dr. Hanzlikshallabstaincompletelyfrom theuseof alcohol.
Absencesfrom Ohio
5. Dr. Hanzlikshallobtainpermissionfrom theBoardfordeparturesorabsencesfrom
Ohio. Suchperiodsofabsenceshallnotreducetheprobationaryterm,unlessotherwise
determinedbymotionoftheBoardforabsencesofthreemonthsorlonger,orby the
SecretaryortheSupervisingMemberoftheBoardforabsencesoflessthan three
months,ininstanceswheretheBoardcanbeassuredthatprobationarymonitoringis
otherwisebeingperformed. Further,theSecretaryandSupervisingMemberoftheBoard
shallhavethediscretiontogrant awaiverof part orallof themonitoringtermsset forth
inthisConsentAgreementforoccasionalperiodsof absence offourteendays or less. In
theeventthatDr.Hanzlikresidesand/orisemployedatalocationthatiswithinfifty
milesofthegeographicborderofOhioand anyof itscontiguousstates,Dr. Hanzlikmay
travelbetweenOhioandthatcontiguousstatewithoutseekingpriorapprovalofthe
SecretaryorSupervisingMemberprovidedthat Dr. Hanzlikisabletootherwise
maintainfullcompliancewithallotherterms,conditionsand limitationssetforth inthis
ConsentAgreement.
Releases:QuarterlyDeclarationsandAppearances
6. Dr. Hanzlikshallprovideauthorization,throughappropriatewrittenconsentforms,for
disclosureofevaluativereports,summaries,and records,of whatevernature,byanyand
all partiesthatprovidetreatmentorevaluationforDr. Hanzlik'schemicaldependencyor
relatedconditions,orforpurposesofcomplyingwiththisConsentAgreement, whether
suchtreatmentorevaluationoccurredbeforeoraftertheeffectivedateofthisConsent
Agreement. Totheextentpermittedbylaw,theabove-mentionedevaluativereports,
summaries,andrecordsareconsideredmedicalrecordsforpurposesof Section149.43 of
theOhioRevisedCodeandareconfidentialpursuanttostatute. Dr.Hanzlikfurther
agreestoprovidetheBoardwrittenconsentpermittinganytreatmentproviderfrom
whomheobtainstreatmenttonotifytheBoardin theeventhefailstoagreetoorcomply
withanytreatmentcontractoraftercarecontract. Failuretoprovidesuchconsent,or
revocation ofsuch consent,shallconstitutea violationof thisConsent Agreement.
7. Dr. HanzlikshallsubmitquarterlydeclarationsunderpenaltyofBoarddisciplinary
actionand/orcriminalprosecution,statingwhethertherehas beencompliancewithall
STEPICONSENTAGREEMENT
SHANER. HANZLIK. M.D.
PAGE4
theconditionsofthisConsentAgreement. Thefirstquarterlydeclarationmustbe
received intheBoard'sofficesonthefirstdayofthethirdmonthfollowingthemonthin
whichthisConsentAgreementbecomeseffective,orasotherwiserequestedbythe
Board. SubsequentquarterlydeclarationsmustbereceivedintheBoard'sofficesonor
beforethefirstdayof everythirdmonth.
8. Dr. Hanzlik.shallappearinpersonforaninterviewbeforethefull Boardoritsdesignated
representativeduringthethirdmonthfollowingtheeffectivedateofthisConsent
Agreement. Subsequentpersonalappearancesmustoccureverythreemonthsthereafter,
and/orasotherwiserequestedbytheBoard. Ifanappearanceismissedorisrescheduled
foranyreason,ensuingappearancesshall bescheduledbasedontheappearancedateas
originallyscheduled.
Drug& AlcoholScreens;DrugTestingFacilityandCollectionSite
9. Dr.Hanzlikshallsubmittorandomurinescreeningsfordrugsandalcoholat leastfour
timespermonth,orasotherwisedirectedbytheBoard. Dr. Hanzlikshallensurethatall
screeningreportsareforwarded directlytotheBoardonaquarterlybasis. Thedrug
testingpanelutilizedmustbeacceptabletotheSecretaryoftheBoard,andshallinclude
Dr. Hanzlik'sdrug(s)of choice.
Dr. Hanzlikshallabstainfromtheuseof anysubstanceandtheconsumptionofpoppy
seeds oranyotherfood orliquidthatm8producealowlevelpositiveresultina
toxicologyscreen. Dr.Hanzlikacknowledgesthat heWlderstandsthattheconsumption
oruseofsuchsubstances,includingbutnotlimitedtosubstancessuchasmouthwashor
handcleaninggel,maycauseapositivedrugscreenthat maynotbeabletobe
differentiatedfrom intentionalingestion,andthereforesuchconsumptionoruseis
prohibitedunderthis Agreement.
AU suchurinescreeningsfordrugsandalcoholshallbeconductedthroughaBoard-
approveddrugtestingfacilityand collectionsitepursuanttotheglobalcontractbetween
saidfacilityandthe thatprovidesforthe Boardtomaintainultimatecontrolover
theurinescreeningprocessandtopreservetheconfidentialityof allpositivescreening
resultsinaccordancewithSection4731.22(F)(5),OhioRevisedCode,andthescreening
processshallrequireadailycall-inprocedure. Further,intheeventthatthe Board
exercisesitsdiscretion,asprovidedinParagraph 10below,toapproveurinescreenings
to beconductedatanalternativedrugtestingfacilityand/orcollectionsiteora
supervisingphysician,suchapprovalshallbeexpresslycontingentupontheBoard
retainingultimatecontrolovertheurinescreeningprocessinamannerthatpreservesthe
aforementionedconfidentialityofallpositivescreeningresults.
Dr.Hanzlikshallsubmit,athisexpenseandonthedayselected,urinespecimensfor
drug and/oralcoholanalysis. AllspecimenssubmittedbyDr.Hanzlikshallbenegative,
exceptforthosesubstancesprescribed,administered,ordispensedtohim in
STEP ICONSENTAGREEMENT
SHANER. HANZLIK, M.D.
PAGE5
conformancewiththeterms,conditionsandlimitationssetforthinthisConsent
Agreement. Refusaltosubmitsuchspecimen,orfailuretosubmitsuchspecimenonthe
dayheisselectedorinsuchmannerastheBoardmayrequest,shallconstitutea
violationofthisConsentAgreement.
Further,withinthirtydaysof theeffectivedateofthisConsent Agreement,Dr.Hanzlik
shallenterintothenecessaryfinancialand/orcontractualarrangementswiththeBoard-
approveddrugtestingfacilityand/orcollectionsiteinorderto facilitatetheurine
screeningprocessinthemannerrequiredbythisConsentAgreement. Further,Dr.
HanzlikshallpromptlyprovidetotheBoardwrittendocumentationof completionof
sucharrangements,includingacopyofanycontractenteredintobetweenDr. Hanzlik
and theBoard-approveddrugtestingfacilityand/orcollectionsite. Dr.Hanzlik'sfailure
totimelycompletesucharrangements,orfailuretotimelyprovidewritten
documentationtothe Board of completion of sucharrangements,shallconstitutea
violationofthisConsentAgreement.
Dr. HanzlikshallensurethattheurinescreeningprocessperformedthroughtheBoard-
approveddrugtestingfacilityand/orcollectionsiterequiresadailycall-inprocedure;
thattheurinespecimensareobtainedonarandom basis;andthat thegivingofthe
specimeniswitnessedbyareliableperson. In addition,Dr.HanzlikandtheBoard-
approveddrug testingfacilityandcollectionsiteshallassurethatappropriatecontrol
overthespecimenismaintainedandshall,immediatelyinformtheBoardof anypositive
screeningresults.
Dr. HanzlikshallensurethattheBoard-approveddrugtestingfacilityand/orcollection
siteprovidesquarterlyreportstothe o r ~ inaformatacceptabletothe o r ~
verifyingwhetherall urinescreenshavebeenconductedincompliancewith this Consent
Agreement,andwhetherallurinescreenshavebeennegative.
In theeventthat theBoard-approveddrugtestingfacilityand/orcollectionsitebecomes
unableorunwillingtoserveasrequiredbythisConsentAgreement,Dr.Hanzlikmust
immediatelynotifythe Boardinwriting,andmakearrangementsacceptabletothe
Board,pursuantto Paragraph10below,assoonaspracticable. Dr.Hanzlikshallfurther
ensurethattheBoard-approveddrugtestingfacilityand/orcollectionsitealsonotifies
theBoarddirectlyofitsinabilitytocontinuetoserveand thereasonstherefore.
Dr. Hanzlikacknowledgesthat theBoardexpresslyreservestherighttowithdrawits
approvalof anydrugtestingfacilityand/orcollectionsitein theeventthattheSecretary
andSupervisingMemberoftheBoarddeterminethatthedrugtestingfacilityand/or
collectionsitehasdemonstratedalackofcooperationinprovidinginformationtothe
Boardorforanyotherreason.
10. Dr. HanzlikandtheBoardagreethatitisthe intentofthis ConsentAgreementthat Dr.
HanzlikshallsubmithisurinespecimenstotheBoard-approveddrugtestingfacilityand
STEPICONSENT AGREEMENT
SHANE R. HANZLIK, M.D.
PAGE6
collectionsitechosenbytheBoard. However,in theeventthatutilizingsaidBoard-
approveddrugtestingfacilityand/orcollectionsitecreatesanextraordinaryhardship
uponDr. Hanzlik,asdeterminedinthesolediscretionoftheBoard,thensubjecttothe
followingrequirements,theBoardmayapproveanalternatedrugtestingfacility and/or
collectionsite,orasupervisingphysician,to facilitatetheurinescreeningprocessforDr.
Hanzlik:
a Within thirty daysof the date upon which Dr. Hanzlikis notified of the Board's
determinationthatutilizingthe Board-approveddrug testingfacilityand/or
collectionsiteconstitutesanextraordinaryhardshipuponDr.Hanzlik,heshall
submitto theBoardinwritingforitspriorapprovaltheidentityofeitheran
alternatedrugtestingfacilityandcollectionsite,orthe nameof aproposed
supervisingphysician,to whomDr. Hanzlikshallsubmittherequiredurine
specimens. Inapprovingafacility,entity,oranindividualtoserveinthiscapacity,
theBoardwillgivepreferenceto afacilitylocatednearDr.Hanzlik'sresidenceor
employmentlocation,ortoaphysicianwhopracticesinthe samelocaleasDr.
Hanzlik. Dr. Hanzlikshallensurethattheurinescreeningprocessperformed
throughthealternatedrugtestingfacilityand/orcollectionsite,orthroughthe
supervisingphysician,requiresadailycall-inprocedure;thattheurinespecimens
areobtainedonarandombasis;andthatthegivingofthespecimeniswitnessedby
areliableperson. Inaddition,Dr. Hanzlikacknowledgesthatthealternatedrug
testingfacilityandcollectionsite,orthesupervisingphysician,shallassurethat
appropriatecontroloverthespecimenis maintainedandshallimmediatelyinform
theBoardofanypositivescreeningresults.
b. Dr.Hanzlikshallensurethatthealternatedrug testingfacilityand/orcollection
site,orthesupervisingphysician,providesquarterlyreportstotheBoard,ina
formatacceptableto the Board,verifyingwhetherallurinescreenshavebeen
conductedincompliancewiththisConsentAgreement,andwhetherall urine
screenshavebeennegative.
c. In theeventthatthedesignatedalternatedrug testingfacilityand/orcollectionsite,
orthesupervisingphysician,becomesunableorWlwillingto soserve,Dr.Hanzlik
mustimmediatelynotifytheBoardinwriting. Dr. Hanzlikshallfurtherensurethat
thepreviouslydesignatedalternatedrugtestingfacilityandcollectionsite,orthe
supervisingphysician,alsonotifiesthe Board directlyoftheinabilitytocontinueto
serveandthereasonstherefore. Further,inordertoensurethat therewillbeno
interruptioninhisurinescreeningprocess,uponthepreviouslyapprovedalternate
drug testingfacility,collectionsite,orsupervisingphysicianbecomingWlableto
serve,Dr. HanzlikshallimmediatelycommenceurinescreeningattheBoard-
approveddrugtestingfacilityandcollectionsitechosenbythe Board,Wltil such
time,ifany,thattheBoardapprovesasubsequentalternatedrugtestingfacility,
collectionsite,orsupervisingphysician,ifrequestedbyDr.Hanzlik.
STEPICONSENTAGREEMENT
SHANER. HANZLIK, M.D.
PAGE7
d. TheBoardexpresslyreservestherightto disapproveanyentityorfacilityproposed
to serveasDr. Hanzlik'sdesignatedalternatedrugtestingfacilityand/orcollection
site,oranypersonproposedto serveashissupervisingphysician,ortowithdraw
approvalof anyentity,facilityorpersonpreviouslyapprovedto soserveinthe
eventthattheSecretaryandSupervisingMemberoftheBoarddeterminethatany
suchentity,facilityorpersonhas demonstratedalackof cooperationinproviding
informationtotheBoardorforanyotherreason.
II. AllscreeningreportsrequiredunderthisConsentAgreementfromtheBoard-approved
drugtestingfacilityand/orcollectionsite,orfromthealternatedrugtestingfacility
and/orcollectionsiteorsupervising mustbereceivedintheBoard'soffices
no laterthantheduedateforDr. Hanzlik'squarterlydeclaration. It isDr.Hanzlik's
responsibilityto ensurethatreportsaretimelysubmitted.
12. TheBoardretainstherighttorequire,andDr.Hanzlikagreesto submit,blood,urine,
breath,salivaand/orhair specimensforscreeningfordrugsandalcohol,foranalysisof
therapeuticlevelsofmedicationsthatmaybeprescribedforDr. orforanyother
purpose,atDr. Hanzlik'sexpenseuponthe Board'srequestandwithoutpriornotice.Dr.
Hanzlik'srefusalto submitaspecimenuponrequestof theBoardshallresultina
minimumofoneyearofactual licensesuspension. Further,thecollectionof such
specimensshallbe witnessedbyarepresentativeoftheBoard,oranotherperson
acceptabletotheSecretaryorSupervisingMemberoftheBoard.
RehabilitationProgram
13. Within thirty daysofthe effective dateof this Consent Agreement, Dr. Hanzlik shall
undertakeandmaintainparticipationinanalcoholanddrugrehabilitationprogram.such
asA.A.,N.A.,C.A.,orCaduceus,no lessthanthreetimesperweek. SubstitUtionof any
otherspecificprogrammustreceivepriorBoardapproval.
Dr. Hanzlikshallsubmitacceptabledocumentaryevidenceof continuingcompliance
withthisprogram,includingsubmissionto theBoardofmeetingattendancelogs,which
mustbe receivedinthe Board'sofficesnolaterthantheduedateforDr. Hanzlik's
quarterlydeclarations.
14. Immediatelyuponcompletionofanyrequiredtreatmentforchemicaldependency,Dr.
HanzlikshallenterintoanaftercarecontractwithaBoard-approvedtreatmentprovider
andshallmaintaincontinuedcompliancewiththetennsof saidaftercarecontract,
providedthat,wherethetermsoftheaftercarecontractconflictwiththe tennsofthis
ConsentAgreement,thetermsofthisConsentAgreementshallcontrol.
STEP ICONSENTAGREEMENT
SHANE R. HANZLIK, M.D.
PAGE8
CONDITIONSFORREINSTATEMENT
15. TheBoardshallnotconsiderreinstatementorrestorationofDr. Hanzlik'straining
certificate,orissuanceof anyothercertificatetoDr.Hanzlik,untilallof thefollowing
conditionsaremet:
a. Dr. Hanzlikshallsubmitanapplicationforreinstatementorrestorationofhis
trainingcertificateoranapplicationforanyothercertificate,asappropriate,
accompaniedbyappropriatefees, ifany.
b. Dr. Hanzlikshalldemonstratetothesatisfactionof theBoardthathecanresume
practiceincompliancewithacceptableandprevailingstandardsofcareunderthe
provisionsof histrainingcertificate. Suchdemonstrationshall includebutshall
notbelimitedtothefollowing:
I. CertificationfromatreatmentproviderapprovedunderSection4731.25of
theRevisedCodethatDr.Hanzlikhassuccessfullycompletedanyrequired
inpatienttreatment,includingatleasttwenty-eightdaysof inpatientor
residentialtreatmentforchemicalabuse/dependence,assetforthinRules
4731-16-02and4731-16-08,OhioAdministrativeCode,completed
consecutively.
11. Evidenceof continuingfull compliancewith,orsuccessfulcompletionof,a
post-dischargeaftercarecontractwithatreatmentproviderapprovedunder
Section4731.25 oftheRevisedCode. Suchevidenceshallinclude,butnot
belimitedto,acopyof thesignedaftercarecontract. Theaftercarecontract
mustcomplywithrule4731-16-10of theAdministrativeCode.
III. Evidenceof continuingfull compliancewiththisConsentAgreement
iv. TwowrittenreportsindicatingthatDr. Hanzlik'sabilitytopracticehasbeen
assessedandthathehasbeenfoundcapableof practicingaccordingto
acceptableandprevailingstandardsofcare. Thereportsshallbemadeby
physiciansknowledgeableintheareaof addictionologyandwhoareeither
affiliatedwithacurrentBoard-approvedtreatmentproviderorotherwisehave
beenapprovedinadvancebytheBoardtoprovideanassessmentof Dr.
Hanzlik. Further,thetwoaforementionedphysiciansshallnotbeaffiliated
withthesametreatmentproviderormedicalgrouppractice. Priortothe
assessments,Dr. Hanzlikshallprovidetheevaluatorswithcopiesof patient
recordsfromanyevaluationsand/ortreatmentthathehasreceived,anda
copyof thisConsentAgreement. Thereportsfromtheevaluatorsshall
includeanyrecommendationsfortreatment,monitoring,orsupervisionof Dr.
Hanzlik,andanyconditions,restrictions,orlimitationsthatshouldbe
STEP ICONSENTAGREEMENT
SHANER. HANZLIK,M.D.
PAGE9
imposedonDr. Hanzlik'spractice. Thereportsshallalsodescribethebasis
fortheevaluator'sdeterminations.
Allreportsrequiredpursuanttothisparagraphshall bebasedupon
examinationsoccurringwithinthethreemonthsimmediatelyprecedingany
applicationforreinstatement. Further,atthediscretionoftheSecretaryand
SupervisingMemberoftheBoard,theBoardmayrequestanupdated
assessmentandreportif theSecretaryandSupervisingMemberdetermine
thatsuchupdatedassessmentandreportiswarrantedforanyreason.
v. IntheeventthattheBoardinitiatesfutureformal proceedingsagainstDr.
Hanzlik, including but notlimited to issuanceof a Noticeof Opportunity for
Hearing,Dr.Hanzlikshallbeineligibleforreinstatementuntilsuch
proceedingsarefullyresolvedbyratificationbytheBoardofasubsequent
ConsentAgreementorissuancebytheBoardof afInal BoardOrder.
c. Dr.Hanzlikshallenterintoawrittenconsentagreementincludingprobationary
terms,conditionsandlimitationsasdeterminedbytheBoardwithin 180daysof
the dateuponwhichalltheabove-specifiedconditionsforreinstatementor
restorationofhistrainingcertificateoranapplicationforothercertificatehave
beencompletedor,if theBoardandDr.HanzlikareWlabletoagreeonthetermsof
awrittenConsentAgreement,thenDr.Hanzlikfurtheragrees toabidebyany
terms,conditionsandlimitatioosimposedbyBoardOrderaftera hearing
conductedpursuanttoChapter119.of theOhioRevisedCode. TheBoardshall
providenoticetoDr.Hanzlikthatsaidhearinghasbeenscheduled,advisingDr.
Hanzlik of hishearingrights,andstating thedate,time,andlocationofthehearing
atwhichtheBoardwillpresentitsevidence,after whichtheBoardwillmakea
determinationof thematterbyBoardOrder.
Further,uponreinstatementorrestorationofDr. Hanzlik'strainingcertificateor
issuanceofanyothercertificateinthisstate,theBoardshallrequirecontinued
monitoringwhichshallinclude,butnotbelimitedto,compliancewiththewritten
consentagreemententeredintobeforereinstatementorwithconditionsimposedby
BoardOrderafter ahearingconductedpursuanttoChapter119.of theRevised
Code. Moreover,uponterminationof theconsentagreementorBoardOrder,Dr.
HanzlikshallsubmittotheBoardforatleasttwoyearsannualprogressreports
madeunderpenaltyofBoarddisciplinaryactionorcriminalprosecutionstating
whetherDr.Hanzlikhasmaintainedsobriety.
16. IntheeventthatDr.Hanzlikhasnotbeenengagedinthe activetrainingand/orpractice
of medicineandsurgeryforaperiodinexcessof twoyearspriortoapplicationfor
reinstatementorrestorationofhistrainingcertificateorapplicationforanyother
certificate,theBoardmayexerciseitsdiscretionWIderSection4731.222,OhioRevised
Code,torequireadditionalevidenceof Dr.Hanzlik'sfitnesstoresumepractice.
STEPICONSENTAGREEMENT
SHANER. HANZLIK, M.D.
PAGE 10
REQUIREDREPORTINGBYLICENSEE
17. WithinthirtydaysoftheeffectivedateofthisConsentAgreement,Dr.Hanzlikshall
provideacopyof thisConsentAgreementto allemployersorentitieswith whichheis
undercontracttoprovidehealthcareservices(includingbutnotlimitedtothirdparty
payors)orisreceivingtraining;andtheChief ofStaff ateachhospitalwherehehas
privilegesorappointments. Further,Dr. Hanzlikshallpromptlyprovideacopyof this
ConsentAgreementtoall employersorentitieswithwhichhecontractstoprovidehealth
careservices,orappliesfororreceivestraining,andtheChief of Staff ateachhospital
whereheappliesfororobtainsprivilegesorappointments. IntheeventthatDr. Hanzlik
providesanyhealthcareservicesorhealthcaredirectionormedicaloversighttoany
emergencymedicalservicesorganizationoremergencymedicalservicesprovider,within
thirty daysofthe effective dateof this Consent AgreementDr.Hanzlik shall provide a
copy of this Consent Agreement to the Ohio DepartmentofPublic Safety, Divisionof
EmergencyMedicalServices. Further,Dr. HanzlikshallprovidetheBoardwithoneof
thefollowingdocwnentsasproofof eachrequirednotificationwithinthirtydaysof the
date ofeach such notification: (1) the return receiptof certified mail within thirty days
.ofreceivingthatreturnreceipt,(2)anacknowledgementof deliverybearingtheoriginal
ink signature of the persontowhom a copyofthe Consent Agreement was hand
delivered,(3)theoriginalfacsimi.le-generntedreportconfinningsuccessfultransmission
ofa copyoftheConsent Agreement to the personor entity to whom a copyof the
ConsentAgreementwasfaxed,or(4)anoriginalcomputer-generatedprintoutof
electronic mail communication documenting the emailtransmissionof a copyofthe
ConsentAgreementtothepersonorentitytowhomacopyofthe ConsentAgreement
wasemailed.
18. Within thirty daysof the effective dateof this Consent Agreement,Dr. Hanzlik shall
provideacopyofthisConsentAgreementtotheproper licensingauthorityof anystate
orjurisdictionin whichhecurrentlyholdsanyprofessionallicense,aswellasanyfederal
agencyorentity,includingbutnotlimitedtotheDrugEnforcementAgency,through
whichhecurrentlyholdsanylicenseorcertificate. Dr. Hanzlikfurtheragreestoprovide
acopyofthisConsentAgreementattimeof applicationtotheproperlicensingauthority
of anystateinwhichheappliesforanyprofessionallicenseorreinstatementof any
professionallicense. Further,Dr. HanzlikshallprovidetheBoardwithoneof the .
followingdocumentsasproof of eachrequirednotificationwithinthirty claysofthe date
of each such notification: (I) the return receiptofcertified mail within thirty daysof
receivingthatreturnreceipt,(2)anacknowledgementof deliverybearingthe originalink
signatureof thepersonto whomacopyof theConsentAgreementwashanddelivered,
(3)theoriginalfacsimile-generatedreportconfinningsuccessfultransmissionofacopy
of theConsentAgreementto thepersonorentitytowhomacopyof theConsent
Agreementwasfaxed,or(4)anoriginalcomputer-generatedprintoutof electronicmail
communication documenting theemail transmissionofa copyof the Consent Agreement
tothepersonorentitytowhomacopyof theConsentAgreementwasemailed.
STEP ICONSENTAGREEMENT
SHANER. HANZLIK, M.D.
PAGE II
19. Dr. HanzlikshallpromptlyprovideacopyofthisConsentAgreementtoallpersonsand
entitiesthatprovideOr. Hanzlikchemicaldependencytreatmentormonitoring. Further,
Dr. Hanzlikshallprovidethe Boardwithoneof thefollowingdocumentsasproofof
eachrequirednotificationwithinthirtydaysofthedateofeachsuchnotification: (1)the
returnreceiptofcertifiedmailwithinthirtydaysofreceivingthatreturnreceipt,(2)an
acknowledgementofdeliverybearingtheoriginalink signatureofthepersontowhoma
copyoftheConsentAgreementwashanddelivered,(3)theoriginalfacsimile-generated
report confinningsuccessfultransmissionof a copyoftheConsent Agreementtothe
personorentityto whomacopyoftheConsentAgreementwasfaxed, or(4)anoriginal
computer-generatedprintoutofelectronicmail-eommunicationdocumentingtheemail
transmissionofacopyoftheConsentAgreementtothepersonorentitytowhomacopy
oftheConsentAgreementwasemailed.
20. Dr. HanzlikshallnotifytheBoardin writingof anychangeof principalpracticeaddress
orresidenceaddresswithinthirty daysofsuchchange.
DURATIONIMODWICATIONOFTERMS
Theabove-describedterms,conditionsandlimitationsmaybeamendedorterminatedinwritingat
anytimeupontheagreementofbothparties. In theeventthattheBoardinitiatesfutureformal
proceedings againstDr. Hanzlik, including but not limited to issuanceofa Noticeof Opportunity
forHearing,thisConsentAgreementshallcontinueinfull forceandeffectuntilsuchtimethatitis
supersededbyratificationbytheBoardof asubsequentConsentAgreementorissuancebythe
Boardof afinal BoardOrder.
In theeventthatanyterm,limitation,orconditioncontainedinthisConsentAgreementis
detennined tobe invalid by a courtof competent jurisdiction,Dr. Hanzlik and the Board agree that
all otherterms,limitations,andconditionscontainedinthisConsentAgreementshallbeunaffected.
FAaURETOCOMPLY
If, inthediscretionof theSecretary andSupervising MemberoftheBoard,Dr. Hanzlik appears to
haveviolatedorbreachedanytermorconditionof thisConsentAgreement,theBoardreservesthe
rightto instituteformal disciplinaryproceedingsfor anyand all possibleviolationsorbreaches,
including butnotlimitedto,allegedviolationsof thelawsof Ohiooccurringbefore theeffective
dateofthisConsentAgreement
ACKNOWLEDGMENTSILIABILITYRELEASE
Dr. Hanzlikacknowledgesthat hehashadanopportunitytoaskquestionsconcerningthetermsof
thisConsentAgreementandthatallquestionsaskedhavebeenansweredinasatisfactorymanner.
STEP I CONSENT AGREEMENT
SHANE R. HANZLIK, M.D.
PAGE 12
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. Hanzlik 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. Hanzlik acknowledges that his social security number will be
used if this information is so reported and agrees to provide his social security nwnber 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.

LANCE A TALMAGE, M.D.
Secretary
;-7 - 1( 'I-/3- 1j
I
DATE DATE
A K C. AMATO, M.D.
S ervising Member U
"" ERIC PLINKE
Attorney for Dr. Hanzlik
I:') .loll
DATE DATE
Enforcement Attorney
DA