Your Delaware nursing license is at risk if you face disciplinary complaints or allegations relating to your substance abuse, addiction, and dependency issues. The Lento Law Firm's premier Professional License Defense Team can help you address those issues for your best licensing and disciplinary outcomes. You may have the Delaware Professionals' Health Monitoring Program available to you as a diversion-from-discipline program. But if so, you should know that diversion programs carry their own risks. Your program, if not appropriate and properly structured, could set you up for failure rather than success. Call 888.535.3686 or complete this contact form now to retain our attorneys for your skilled and experienced representation. You have invested a great deal in your Delaware nursing license and practice.
Substance Abuse, Addiction, and Dependency in Nursing
Healthcare professionals, in general, suffer a higher incidence of substance abuse than the general population, in part because of professional practice stresses but also largely because of their unusual access to controlled substances used for prescription medication and treatment of disease. Nurses are not immune to those substance abuse problems. The Journal of Nursing Regulation admits that nurses abuse prescription drugs at higher rates than patients and the general population. Nurses also suffer from drug disorders and abuse stimulants to get through their work at greater rates than other workers. About eighteen percent of nurses in clinical practice have substance abuse problems, which amounts to nearly one out of every five nurses. Many of those nurses have diagnosed or diagnosable substance use disorders. Clinical nursing practice is the substance abuse driver. Nursing educators and researchers have only about one-tenth the substance abuse rates of nurses in clinical practice. Nursing is hard, and many nurses compensate with self-medication and abusing substances.
Triggers for Nursing Substance Abuse and Dependency
Stress from nursing practice is undoubtedly a contributing factor to the high nursing substance abuse rates. The National Library of Medicine shares a study showing significant stress among nurses nationwide. Nursing is getting harder, not easier. You already know from your own nursing practice how the challenges of nursing can lead to substance abuse, addiction, and dependency problems. Stress combines with easy access to prescription medications and other hallucinogens to produce high diversion, theft, misuse, and abuse rates. And it's not only workplace issues that trip up nurses, triggering substance abuse disciplinary charges. Nurses also get caught and charged for drunk driving or come to work under the influence of drugs, alcohol, or over-prescribed medications, where colleagues, employer representatives, or patients report them. It's hard to hide a substance abuse, addiction, or dependency problem in nursing practice. Chances are good that the abusing, addicted, or dependent nurse will, at some point, get caught and face disciplinary issues.
Regulation of Delaware Nursing Practice
Delaware's Board of Nursing, supported by the Division of Professional Regulation, licenses nurses who wish to practice in the state. You obtained your Delaware nursing license through the Division of Professional Regulation, whether by examination or endorsement. The Board of Nursing and the Division of Professional Regulation also work together to investigate, charge, and discipline nurses who violate the Board of Nursing's standards. The Board of Nursing publishes its disciplinary actions against nurses, giving out their names, sanctions, and wrongs online for anyone to see. You won't be able to hide your discipline from your employer, patients, colleagues, family members, professional network, or friends. Prepare to fight disciplinary charges rather than ignore the charges or give in to the charges by relinquishing your license. You may well have a valid and provable defense. Retain our skilled attorneys to advocate your defenses for your best disciplinary outcome.
Delaware Nursing Substance Abuse Issues
While nurse substance abuse is a nationwide issue for the nursing profession, substance abuse is also an issue for Delaware nurses specifically. A Delaware Online report indicates that of the hundreds of Delaware nurses whom the Division of Professional Regulation sanctions for misconduct, 28% of those nurses suffered discipline for substance abuse issues. The number of cases in which substance abuse was a contributing factor and not the direct offense is likely far higher. Most cases of nurse substance abuse involve prescription drugs. However, substantial numbers of nurses abuse illicit drugs or alcohol. A mix of alcohol, prescription or illicit drugs, and other stimulants and depressants affects many other nurses. When nurses suffer from work and other life stressors, they reach for what is available, just like the rest of the population. You are not alone as a nurse with your substance abuse, addiction, and dependency issues.
Available Delaware Nursing Intervention Program
Delaware's Board of Nursing and Division of Professional Regulation are well aware of the problems substance abuse causes for nurses. They are also willing, in many cases, to treat the problem as a medical issue rather than a moral and character issue, at least where the nurse has not committed a serious crime or harmed patients. With legislative authorization and Board of Nursing approval, Delaware's Division of Professional Regulation established the Delaware Professionals' Health Monitoring Program as an intervention and diversion program for nurses and other healthcare professionals suffering from substance abuse issues. You may qualify for participation in that diversion program. Get our review and advice before agreeing to its proposed terms for your participation.
Delaware Health Monitoring Program Participation
You may or may not be able to participate in Delaware's substance abuse intervention and diversion program for nurses. Your participation may or may not be wise, necessary, or appropriate. Let us help you determine your eligibility and whether your participation is wise and likely to be helpful. The Division put out a statement inviting professionals to participate in its approved diversion program, hoping to encourage greater participation. The statement reads that the division “is aware of the difficulties faced by many of our licensees" in nursing practice. The statement continues, "The Delaware Professionals' Health Monitoring program is open to licensees with substance use disorders or mental health issues that could impact their professional practice.” The Division's statement reminded nurses that they can self-enroll in the program only if they do not already face a disciplinable offense. If, instead, you face disciplinary charges or allegations of a disciplinable offense, then you must obtain the approval of the Delaware Division of Professional Regulation to hold your disciplinary charges in abeyance pending your program enrollment and participation.
Delaware Health Monitoring Program Features
The Delaware Professionals' Health Monitoring Program associates with a national for-profit health services and technology provider, Uprise Health, to provide or arrange and refer for intervention, evaluation, treatment, and monitoring services. The Health Monitoring Program itself may not provide substantial services but may rely on Uprise Health and other professional providers. The Program may arrange or refer and provide for the following services:
- evaluation of your substance abuse, addiction, and dependency issues;
- determination of an appropriate treatment plan for your issues;
- monitoring of your plan to ensure your timely compliance;
- toxicology testing to ensure your consistent compliance;
- administrative forms and guidelines;
- a payment system allowing you to make and track payments; and
- a website for the state to track your compliance.
How Substance Abuse Diversion Should Work
In theory, diversion can be a good system. In practice, it is generally more complex than that. Participants have three ways to get into the Delaware Professionals' Health Monitoring Program: (1) voluntarily self-referral; (2) referral by a colleague, employer, or other third party who contacts the Division of Professional Regulation or the Health Monitoring Program; or (3) an order from the Board of Nursing or Division of Professional Regulation, out of a disciplinary proceeding. If you self-refer or receive a colleague's referral, then the intake process will require you to divulge any criminal drug charges, patient harm, or other nursing standards violations related to your substance abuse issue. If you have any of those issues, the Program will refer you to disciplinary officials. Otherwise, the Program will determine your eligibility. If you are eligible, then the Program will develop a program plan. Once you agree to the plan, the Program will monitor your compliance. If you fully comply and complete the plan, then the Program may recommend dismissal or other favorable disposition of any associated disciplinary charges.
The Delaware Health Monitoring Program Plan
You are not at liberty to fashion your own substance abuse treatment and recovery plan. You are also not at liberty to choose your own examiners and treaters. In general, you should expect the Delaware Professionals' Health Monitoring Program officials to establish the terms, conditions, and third-party providers for your plan. Those officials will primarily rely on Uprise Health personnel to specify, arrange, and provide for those services. The Division of Professional Regulation's website acknowledges that Health Monitoring Program services “are provided by Uprise Health, an independent behavioral health services organization.” Your Health Monitoring Program plan may include any or all of the above obligations, as well as other activities:
- that you appear for examination before certain mental health and addiction professionals and cooperate with your examination at your cost without regard to your health insurance plan coverage;
- that you submit to regular drug and alcohol testing at the plan's designated times and places even if inconvenient to you and your other scheduled work, school, or family obligations;
- that you submit to mental health and addiction treatments your examiners specify in the programs they choose, at their designated dates, times, and places, whether or not convenient to you;
- that you comply with all psychiatric, psychotherapeutic, counseling, medical, or other treatment regimens, whether or not acceptable or affordable to you;
- that you authorize the Program to share your confidential medical information, logs, test results, and reports with all examining and treating providers and with the Division of Professional Regulation and other agency officials;
- that you restrict your personal and social activities to avoid restaurants, clubs, bars, sporting events, and other events and locations serving alcohol;
- that you abstain from all alcohol and drugs, including restrictions on prescription medications that you may have been taking for years to relieve other health conditions;
- that you pay all program fees, charges, costs, and expenses, including paying for all testing, evaluation, and treatment, even if not insured for those expenses, and even if your own providers would have performed the same services covered by your health insurance; and
- that you accept specified and unspecified penalties, some of them presumptive and automatic, for your non-compliance, including but not limited to your repeat evaluation, repeat testing, and repeat or supplemental treatment, up to program dismissal and referral for discipline.
Negotiating Delaware Health Monitoring Program Terms
You may not like the terms and conditions the Delaware Professionals' Health Monitoring Program officials propose and impose for your plan. You may reasonably believe that you do not need the evaluation, testing, and treatment your plan would require. You may also not be able to afford the plan or may have alternative medical providers whose equivalent services your health insurance would cover. You may also reasonably believe that you would find complying with the plan to be difficult or impossible in certain ways or that compliance would substantially interfere with your work, schooling, or family responsibilities. Yet you may find that Program officials are unwilling to accept your change proposals and are even distrustful of your representations. Let us help you determine whether you can meet your proposed plan and whether you can negotiate better terms. Our attorneys have the advocacy, negotiation, and communication skills to help you get your best diversion plan terms if diversion is your best option. Don't agree to a plan that sets you up for failure. Get our advice and representation.
Delaware Health Monitoring Program Accountability
Delaware Professionals' Health Monitoring Program officials will monitor your compliance with your Program plan to ensure your accountability to all of its terms and conditions. They accomplish monitoring by requiring examining and treating providers to submit regular evaluation and treatment reports and by requiring you to complete weekly or more frequent plan logs. They also receive and review copies of drug and alcohol testing results and other data. If Program officials find that you are missing scheduled drug test drops, producing non-compliant drug test specimens, failing to appear for scheduled treatment and counseling, or failing to cooperate with treatment recommendations and plan restrictions, then those officials may advocate against you instead of on your behalf with disciplinary officials. In theory, your Program plan administrator should be your ally, ready to show how compliant you have been. But in practice, plans can be so arduous that non-compliance is likely or inevitable, in which case your plan administrator may become your adversary rather than your friend. Let us help ensure you enter into only a fair plan if diversion is your best option.
How Long Delaware Health Monitoring Lasts
It would be reasonable to expect that substance abuse evaluation and treatment might take up to six months or maybe up to nine months or even one year at most. You might thus expect that the Division of Professional Regulation and Health Monitoring Program would propose a plan for no longer than that limited duration. However, some plans may last not just one year but two, three, four, or even five years. You would be right to think that a lot can change in five years that would make your plan compliance difficult, unreasonably burdensome, impossible, or plainly unnecessary. But if your plan is for five years, you may find Program officials unwilling to modify it, even after your long compliance. Your consent to the plan presumes your consent to its full duration. Don't agree to a long-term plan without our review, advice, negotiation, and advocacy. Shortening your plan to a reasonable period may be your best option and saving grace.
Issues with Delaware Nursing Intervention Diversion
You should see from the above discussion many of the serious issues that a Delaware Professionals' Health Monitoring Program plan may raise, even so serious as to make your situation worse rather than better. It may already be obvious to you that your better option is to retain us to dispute the disciplinary charges rather than entertain an arduous diversion plan that sets you up for failure. But consider the following summary of the general and specific risks of diversion plans, even as you retain our attorneys for review, evaluation, advice, and negotiation.
Procedural Issues with Delaware Health Monitoring Program Diversion
When Division of Professional Regulation officials tell you to accept diversion and Health Monitoring Program officials hand you the plan containing your terms and conditions; they may not explain to you that you have the right to our skilled and experienced representation. They may state or suggest that they have given you take-it-or-leave-it, non-negotiable terms as your only option or as your clear best option. They are not, however, your advocates. They are, instead, your adversaries, having clear conflicts of interest when purporting to advise you. Your correct procedural move is to retain us for review, evaluation, advice, and advocacy. Be smart. Don't submit to pressure tactics. Get our help.
Substantive Issues with Delaware Health Monitoring Program Diversion
When you receive the Health Monitoring Program's proposed terms and conditions for your disciplinary diversion, you are generally looking at a blunt instrument that makes all kinds of assumptions about your personal character, health, habits, practices, problems, and discipline. You know yourself far better than the officials who drafted your plan, which doubtless came from a template that they use for other nurses with different characters, issues, practices, and problems. Every individual is unique. Your evaluation and treatment needs and interests differ from every other nurse facing disciplinary diversion. Don't agree to a bad plan. Let us help you negotiate a better plan or reject diversion in favor of fighting the disciplinary allegations.
Non-Compliance Issues with Delaware Health Monitoring Program Plans
You've seen above that diversion plans can also be arduous, unreasonable, and even so demanding that your non-compliance becomes not just likely but inevitable. You might assume that Health Monitoring Program officials would treat your minor non-compliance reasonably, excusing you for extenuating circumstances or even circumstances entirely beyond your control. But the plan itself or the Program's guidance and practices may include one-strike clauses, automatic discipline, or presumptive discipline for even minor non-compliance issues beyond your control. Beware of terms and conditions regarding non-compliance.
Fighting Delaware Disciplinary Charges Instead of Accepting Diversion
Finally, of all the issues with a proposed Delaware Professionals' Health Monitoring Program plan, your biggest issue may be that fighting the disciplinary charges is a better route for your best outcome than accepting diversion. You may simply not need substance abuse, addiction, or dependency evaluation and treatment. You may have already addressed your substance use issues on your own or are addressing them in a sound recovery plan chosen by you and your trusted medical team, who would be providing services covered by your health insurance. You may also not have committed the alleged disciplinary violations. We may be able to identify, acquire, and present substantial exonerating and mitigating evidence. Let us help you decide.
Delaware Health Monitoring Program Non-Compliance
It bears mentioning separately that non-compliance with your Delaware Professionals' Health Monitoring Program plan may be your bigger risk than the disciplinary charges you already face or expect to face. As already indicated, disciplinary officials understand the nature, risk, and impact of substance abuse among nurses. They can be remarkably sympathetic to a nurse with substance abuse, addiction, and dependency issues, especially if the nurse has not committed a serious crime or caused any patient harm. Substance abuse in those situations may be much more an illness than a character issue. But if you violate a diversion plan that you approved and accepted, then you may suddenly look to those same disciplinary officials as if you have poor commitment and character, not just a treatable or already cured substance abuse issue. Your better avenue for your best outcome may indeed be to fight the charges than to consent to an inappropriate diversion plan.
Confidentiality of Delaware Monitoring Program Participation
You may read or hear that your Delaware Professionals' Health Monitoring Program participation is confidential. But it is not as confidential as you may think and could instead lead to widespread disclosure and knowledge within your healthcare community that you have or had a substance abuse, addiction, or dependency issue. To comply with a diversion plan, you will likely need to disclose it to your employer because of schedule adjustments alone, if not for other reasons. Word may quickly spread throughout your workplace. Your family members are also likely to learn simply from your need to attend drug testing, evaluation, and treatment sessions. If you are in a school program, you may need relief from your school schedule for the same obligations, leading to widespread knowledge among school officials of your substance abuse issue. The plan providers themselves will share your substance abuse and medical information among themselves and with state agency officials. That's not very confidential.
Premier Delaware Nursing License Defense
If you face or expect to face Delaware nursing disciplinary charges relating to substance abuse issues and are considering a diversion offer, retain the Lento Law Firm's premier Professional License Defense Team to review, evaluate, advise, negotiate, and advocate for a workable, fair, helpful, and achievable plan, or to fight the disciplinary charges if that is your better option. Call 888.535.3686 or complete this contact form now for our skilled and experienced representation.
