Federation of State Physician Health Programs

FSPHP Homepage About the FSPHP State Programs Meetings Publications Contact Us	Connecticut Demographics and staff - member Program Name: Physician Health Program Connecticut State Medical Society Address: 160 St. Ronan Street New Haven, CT 06511-2390 Telephone:  (203) 865-0587 Fax:  (203) 492-4170 E-mail:   cholmes@csms.org Web site: www.csms.org Staff: Douglas W. Gibson, MD, Medical Director Christi Holmes, Manager Program structure The program is operated by: State medical society Do you have a formal contractual relationship with the state medical board? Yes We have a protocol agreement with the Connecticut Department of Public Health, not directly with the State Medical Board Program services Types of disease, illness, or conditions monitored: Chemical dependency Mental health Behavioral health problems Physical illness Services provided to which populations: Physicians - MD Physicians - DO Residents Funding Please indicate the primary sources of funding for your program: State medical society (70 percent) Malpractice insurance companies Hospital and private contributions Participant fees: None Other: A 501(c)(3) fund is also the recipient of contributions by medical staffs and HMOs, which are used for grants and loans to physicians in the program for treatment purposes; and for general educational programs Monitoring requirements Chemical dependency Length of contract: 5 years Random urine drug screen frequency: Year 1: 2 times per week Year 2: 2 times per week Year 3: 2 times per month Year 4: 2 times per month Year 5: 1 time per month Note: this may vary Support (self help) group requirements: AA NA Caduceus Other:  On case-by-case basis Support (self help) group frequency: Year 1: 4-5 times per week Year 2: average 8-12 per month Year 3: average 8-12 per month Year 4: average 8-12 per month Year 5: average 8-12 per month To completion: aerage 8-12 per month Therapy or treatment requirement: Any therapy or Tx is based on recommendation of evaluator and/or inpatient Tx team, including frequency and duration, subsequently at the recommendation of the treating therapist. Work or practice monitor requirement: Hospital chief (dept) and practice associate and/or employer required to submit quarterly reports to PHP if all is okay; immediately it not Other provisions: Periodic meetings with PHP representatives Mental health Length of contract: Varies based on treating therapist recommendation Support (self help) group requirements:  On case-by-case basis. Support (self help) group frequency:  On case-by-case basis. Therapy or treatment requirement: Therapy or Tx initially determined by evaluators; subsequently determined by treating therapist Work or practice monitor requirement: Hospital chief (dept) and practice associate and/or employer required to submit quarterly reports to PHP if all is okay; immediately it not Other provisions: Periodic meetings with PHP representatives Please describe any other monitoring services provided: The PHP also provides advocacy for physicians in program with various credentialing entities, malpractice insurers, regulatory agencies, HMO's, hospital medical staffs, disability and life insurers, prospective employers, and others.