Friday, March 11, 2022

Nurse practitioner who treated the late actress Stevie Ryan stripped of California licenses

Actress Stevie Ryan, seen in 2012, starred in the VH1 sketch comedy show “Stevie TV,” which aired for two seasons.
(Tiffany Rose / WireImage)

By Daniel Miller

The nurse practitioner who treated actress Stevie Ryan — and engaged in a sexual relationship with her months before she killed herself in 2017 — has been stripped of his California licenses, the state’s Board of Registered Nursing said last week.

The move, effective Feb. 28, came after the nurse, Gerald “Jay” Baltz, lost an administrative law proceeding that focused on his treatment of Ryan, known for her pioneering YouTube videos and her VH1 sketch comedy show “Stevie TV.” The case had been initiated by the head of the nursing board, an agency within the state’s Department of Consumer Affairs. Baltz is challenging the decision in Los Angeles County Superior Court.

The formal accusation, brought against Baltz in 2020, sought the suspension or revocation of his nursing licenses for alleged misconduct subject to discipline under the California Business and Professions Code. The legal filing accused him of gross negligence, incompetence, unprofessional conduct and sexual misconduct.

A Times investigation, published in April 2021, detailed Ryan’s rise in Hollywood, her entanglement with Baltz, and her death at 33. Told of the nursing board’s decision, Steve Ryan, the late actress’ father, said, “I guess that’s good news.” 

“It’s hard to feel good about something that is that life altering for both parties,” he said.

In the accusation, Baltz was alleged to have engaged in an inappropriate, boundary-crossing relationship with Ryan while she was his patient, and then a sexual relationship with her while she was receiving treatment at the facility where he worked. It also said that Baltz allegedly issued Ryan prescriptions for about 10 drugs used to treat a variety of conditions — including depression and bipolar disorder — without providing “clear rationale for prescribed medications.” He also allegedly failed to seek supervision for her when she was suicidal, the accusation said.

Following a hearing last fall, a judge from the state’s Office of Administrative Hearings issued a proposed decision in November that ordered Baltz’s four state nursing licenses be revoked. The judge wrote that there was cause to discipline Baltz for unprofessional conduct and gross negligence, but not for incompetence or sexual misconduct, in part because Ryan was no longer his patient at the time their relationship became intimate. The Business and Professions Code says that “any act of sexual abuse, misconduct, or relations” with a client is grounds for discipline, but does not note this applies for former clients.  

Ryan asked out Baltz during an April 5, 2017, visit, the proposed decision said. That day, Baltz terminated his nurse-patient relationship with Ryan and transferred her care to another mental health provider at Insight Choices, the facility where he worked, the filing said. Baltz and Ryan dated briefly: They ended things in late April via a text message chat, during which Baltz said he hoped she would “never say anything” about their romantic relationship, according to the decision.

Three months later, Ryan took her own life.

Baltz’s “breach of professional boundaries with a former patient with known mental health infirmities evinces a serious lapse in judgment,” the judge wrote in the proposed decision.

At the hearing, Baltz explained that he felt “terrible” over his romantic relationship with Ryan, and blamed engaging in it on his alcohol abuse, according to the decision. (He said he has been sober since May 2017.) Baltz defended the rationale of his prescribing activity but also acknowledged that he had lied to a nursing board investigator during a 2019 interview in which he was asked about his relationship with Ryan, saying that he did so because he “felt guilty and afraid,” it said.

The nursing board adopted the decision in January, but Baltz filed a petition for reconsideration Feb. 14. It argued, in part, that revoking Baltz’s licenses was “improper and punitive” due to, among other factors, the judge having erroneously interpreted the law in finding that Baltz had committed unprofessional conduct by having a sexual relationship with Ryan after he stopped treating her. The petition was denied by the board Feb. 24.

Baltz, who left Insight Choices a month after Ryan’s death and has more recently practiced at MelrosePsych in the Beverly Grove neighborhood, will be eligible to seek the reinstatement of his licenses in three years, according to the nursing board.

Via his attorneys, Baltz declined multiple interview requests. In an interview with The Times, one of his lawyers, Michael Khouri, said that “for many years, Gerald Baltz has been a highly regarded nurse practitioner with a large patient following who all say nothing but wonderful things about the man.”

Khouri downplayed some of the allegations Baltz faced, including those that pertained to the intake note he wrote when he began providing care to Ryan in 2015. The note allegedly “provided scant information” and “failed to document” elements of Ryan’s health history, the accusation said. “If every doctor in California was disciplined because their notes weren’t complete, there would be no doctors,” Khouri said.

Baltz is a nurse practitioner — a registered nurse with additional education, allowing him to prescribe medicine and offer diagnoses, among other activities. With such responsibilities, nurse practitioners, whose work in California requires physician oversight, have a unique role in the healthcare system, a fact highlighted at Baltz’s hearing in October before the administrative law judge.

Stevie Ryan, seen in 2008, took her own life in 2017 at the age of 33.
(Charley Gallay/Getty Images)

A major area of disagreement at the hearing centered on Baltz’s actions when Ryan felt suicidal. California law obligates nurses who observe “abnormal characteristics” in patients to initiate “appropriate reporting, or referral” to others in the medical field.

The judge’s decision quoted Baltz’s notes from his sessions with Ryan, including one from their final visit that said “she feels suicidal.” A nurse practitioner who served as an expert witness for the head of the nursing board said that Baltz failed to refer Ryan to a higher level of care. Baltz opted to refer Ryan to his supervising physician for a specialized course of treatment, a move the witness described as substandard.

Baltz testified that Ryan “was not at inherent risk for suicide because she endorsed a passive death wish for multiple years,” the decision said. He also said he believed he had referred the issue “to an appropriate level of higher care” with his supervising physician. The judge noted, however, that there was no “indication that [Baltz] ever performed any suicide risk assessment” for Ryan, even after her complaint of feeling suicidal at their last session. Therefore, the judge wrote, it was “questionable” how Baltz had concluded that treatment with the physician was appropriate instead of “a referral to a psychiatric hospital or emergency care.”

The judge noted that Baltz had submitted positive character reference letters and completed an educational training program on professional boundaries. The decision also explained that a clinical counselor who served as an expert witness for Baltz conducted a “sex offender risk assessment” of the nurse and found that he “is not at risk for re-offending sexually.” Nonetheless, the judge wrote that Baltz had shown “little evidence of rehabilitation,” saying that he had provided no “concrete plans to prevent the reoccurrence of a similar incident.” 

Baltz “was grossly negligent in failing to provide care or to exercise ordinary precaution in [Ryan’s] case, which he knew, or should have known, could have jeopardized that patient’s health or life,” the judge said.

Khouri, Baltz’s attorney, said that “society is worse off having his license revoked.”

“Is he remorseful for what happened? Of course he is,” Khouri said. “Do we respect the board’s power to render judgments on professional rules violations? Of course we do. But we disagree with the penalty.”

To that end, Baltz is continuing to pursue the matter: On Feb. 16, he filed a petition for writ of administrative mandate in L.A. County Superior Court. The filing asked the court to vacate the decision to revoke Baltz’s licenses, arguing that the nursing board misinterpreted and misapplied relevant statutes in its disciplining of him, among other contentions.

The nursing board declined to comment on Baltz’s court filing, a spokesman said, explaining that it doesn’t discuss active litigation. The parties will meet May 26 to set a trial date.

Baltz is not practicing in California as he awaits the outcome of his court challenge: Telephone calls to MelrosePsych
this week were met by an automated message that said another provider is “covering for Dr. Baltz in the interim.” He also has nursing licenses in Colorado and Washington, but their status is now in flux.

According to an August filing with Colorado’s Board of Nursing, Baltz voluntarily agreed to a “non-disciplinary interim cessation of practice agreement” while it investigated claims surrounding his conduct in California. Baltz denied he violated the Nurse Practice Act, the legal document said.

In Washington, Baltz faces the revocation, restriction or suspension of his license after being accused of unprofessional conduct by the state’s Nursing Care Quality Assurance Commission, which, in a December statement of charges, cited allegations he faced here.

Friends of Ryan including Yuni Kim said that they were thankful for the nursing board’s decision to revoke Baltz’s California licenses. He had continued to work during the board’s years-long scrutiny of his actions.

“I feel relief — I also feel like I want to cry, because it should have never come to this,” said Kim, who began sobbing. “The relief is mired with grief. She was my best friend.”

Full Article & Source:

No comments: