Indiana has a monitoring program that nurses accused of substance abuse, or who are suffering from substance abuse issues, can enroll in to receive intensive and comprehensive treatment for those issues. Enrolling in the Indiana Professionals Recovery Program (IPRP) will also allow the nurse to defer and, if the program is completed successfully, avoid the Board of Nursing disciplinary action related to their substance abuse. Indiana's IPRP is not for everybody, however, and if you are considering enrolling or have been referred by the Indiana State Board of Nursing (BON), contact the Lento Law Firm Professional License Defense Team to learn more about what that means for you and what your options might be. Call us today at 888.535.3686 or use our contact form to set up a confidential consultation.
What is Indiana's IPRP?
Indiana's IPRP provides nurses who are suffering from substance abuse issues, or who have been referred to the IPRP program by the BON because of suspected substance abuse issues, to receive comprehensive monitoring and counseling for those problems. It employs a multi-pronged approach that includes daily check-ins, frequent group meetings, individual counseling, and monitored work experiences during the term of the nurse's enrollment in the program. While a nurse is enrolled in the IPRP, they will not be disciplined for misconduct allegations that were the basis of their enrollment, and if they successfully exit the program, there will be no disciplinary proceedings or consequences related to those allegations.
The IPRP program can be voluntary; a nurse can self-refer if they believe the IPRP is their best chance of combatting a substance abuse problem. The BON can also require a nurse to enroll in the IPRP, with the alternative being that the BON will pursue disciplinary charges against the nurse. In some cases, the Office of the Indiana Attorney General will make the referral if the nurse has been criminally charged with a substance abuse-related offense. If a nurse leaves the IPRP program before completing their agreed-upon treatment, the IPRP program will, in most cases, notify the BON, and any disciplinary proceedings against the nurse related to their substance abuse behavior may be resumed.
Whether you're considering voluntarily enrolling in the IPRP program, or have been referred to the program by the BON or Office of the Attorney General, the Lento Law Firm Professional License Defense Team can help you understand what you can expect if you enroll. We can also help you explore other options so that no matter which you select, you'll know you were choosing what you believe is best for you.
Enrolling in IPRP
When a nurse contacts the IPRP, whether voluntarily or as a result of being told to do so by the BON, there is an intake and evaluation process that the IPRP program follows. This includes the following steps:
- The nurse will contact IPRP staff and will complete a phone evaluation and questionnaire
- The nurse will undergo an “intake assessment” by a professional affiliated with IPRP
- IPRP staff will recommend a treatment plan for the nurse
- If the nurse agrees to the treatment plan, the nurse will sign a Recovery Monitoring Agreement (RMA) that describes in detail what the components of the nurse's treatment plan are and that acts as a roadmap for the nurse's future treatment in the IPRP
Nurses who enroll in the IPRP program can expect to remain in the program anywhere from three to five years. As part of their initial participation in the program, they will – in almost every case – not be allowed to work as a nurse until they have permission from the IPRP staff to do so. This is one of the significant challenges of enrolling in the IPRP program, particularly if you're self-referring; you will not be working as a nurse for an unknown period of time until IPRP staff permits you to do so. In addition, you will be expected to pay for random drug tests as well as any costs associated with your required group meetings, AA/NA meetings, individual therapy, and medical consultations related to the program.
Participating in the IPRP Program
IPRP program participants sign a detailed IPRP Recovery Monitoring Agreement or RMA. The typical RMA will impose the following requirements on the nurse:
- The nurse will immediately stop working until allowed to return to work by IPRP staff
- Consumption of alcohol (in any form, including in over-the-counter medication) is prohibited, as well as consumption of any substances that include ephedrine, diphenhydramine, THC, or products that will produce a positive result to a drug screen
- The use of any form of CBD Oil is not allowed; Kombucha tea, Kratom, nitrous oxide, poppy seeds, or vanilla extract may not be consumed; and the nurse may not use hand sanitizer or mouthwash
- The nurse must consent to the IPRP accessing the nurse's prescription drug information
- Random drug screening is required, initially at least 16 times per year, but possibly more depending on the nurse's situation
- Daily check-ins with the IPRP drug testing provider
- Enrollment in the medical, psychiatric, or substance abuse treatment and counseling programs as IPRP may direct, including 12-step and other support groups
- Submission of periodic reports from treatment providers and from the nurse
The RMA will have a specified end date. That said, whether and when the nurse successfully exits the program is up to IPRP staff. IPRP can extend or terminate the nurse's enrollment in the program depending on the facts of the nurse's particular situation.
As you can see, enrolling in Indiana's IPRP program means making a substantial commitment of time, energy, and money that can continue for years. This is why it makes sense to learn about all of the options that may be available to you before you sign an RMA. The Lento Law Firm Professional License Defense Team has the experience to help you understand what your options are and can guide you in making the choice that's best for you.
Employment While Participating in the IPRP Program
In almost every case, a nurse who enrolls in the IPRP will have to stop working as a nurse until the IPRP staff authorizes the nurse to return. Because one of the goals of the IPRP is to ensure that patients are cared for safely by nursing staff, the immediate removal of a newly enrolled nurse is generally considered one of the requirements of participating in the IPRP program. Only after the nurse has a suitable track record in the program will IPRP staff consider a request to return to work.
When a nurse is approved to return to work, it is usually with some conditions. The IPRP may set a maximum number of work hours per week , designate what shifts the nurse will be allowed to work, restrict the nurse's access to prescription medication, including narcotics, or define the type or location of the work setting where the nurse will be employed.
The Employment Process While Participating in IPRP
There are a number of steps involved in returning to employment after initially enrolling in the IPRP program.
- The nurse must request and get permission from IPRP staff to look for work
- As part of this, in most cases, the nurse will need to submit a “return-to-work” assessment that must be completed by a board-certified addiction medicine physician, psychiatrist, or psychiatric nurse practitioner
- The IPRP Medical Director and Program Director will review the nurse's request and return-to-work assessment and, in cases where the nurse is approved to return to work, will provide the nurse with guidelines that the nurse must follow as part of returning to work
- If a return-to-work assessment isn't required by the nurse's RMA, the nurse must still receive permission to return to work from their Clinical Case Manager (CCM)
- The nurse must inform prospective employers of the nurse's enrollment in IPRP
- The employer must agree to appoint a worksite monitor who will be responsible for supervising the nurse and submitting periodic reports to IPRP on the nurse's workplace behavior
- The nurse must give the worksite monitor a copy of the nurse's RMA; the monitor will need to sign it, and the nurse's employer will have to return the signed copy to the nurse's CCM at IPRP
- If the employer or the nurse wants to change any of the conditions that IPRP places on the nurse's employment – hours or shifts worked, the nurse's worksite monitor, where the nurse is working, or lifting a medication restriction – the nurse must get IPRP's approval before the change takes place
The many steps involved in returning to employment make that process more time-consuming and difficult than it would be if the nurse were not enrolled in the IPRP. While the requirements were designed with the well-being of nurses and patients in mind, they are something that you need to be aware of and take into account if you're considering enrolling in Indiana's IPRP. The Lento Law Firm Professional License Defense Team can help you understand the employment restrictions and requirements of the IPRP program and decide if the IPRP program is best for you.
Travel While Participating in IPRP
Because of the daily check-in requirements and having to be constantly available for random drug testing, travel can be a challenge. Nurses who will be away from home for any more than a day need to submit a Monitoring Interruption Request to the IPRP's program administrator in advance of their travel date. If a drug testing site is available in the area where the nurse will be traveling, they will still need to contact the IPRP drug testing provider daily and be ready to submit to a drug test at that location. In cases where there are no testing sites at the travel destination, the nurse may be required to submit to enhanced drug testing – namely, hair, fingernail, or blood testing – when they return.
Medical Prescriptions of Medications
Nurses who are hospitalized or are receiving medical or dental treatment that involves the prescription of medications that are otherwise prohibited by the nurse's RMA must report the matter to IPRP and to their various IPRP treatment providers – both verbally and in writing. They will have to submit documentation supporting the prescription to their CCM within 72 hours of receiving the prescription, and they will also need to add the prescription to their IPRP medications list. If the prescription is for a controlled substance that is otherwise banned as part of the IPRP program, the nurse must notify their CCM immediately. One consequence of this is that the nurse may be directed not to return to work for a period of time, for example, until at least 24 hours after they stop taking the medication.
Prescription Waivers
Some nurses enrolled in the IPRP program may be suffering from chronic pain issues resulting from injuries or a debilitating disease – medical issues that would normally result in the nurse being prescribed pain medication on an ongoing basis. This can be a challenge when the nurse is also enrolled in the IPRP program. Indiana addresses this challenge by requiring the nurse to bring it to the attention of the IPRP and to have the nurse's prescribing physician consult with the IPRP's clinical team and the nurse's Addiction Physician about the pain medication issue.
Exiting the IPRP Program
The target for each nurse's completion of the IPRP program is the end date listed on their RMA. But because of the nature of the IPRP program, that end date is more of a target than a certainty. Much depends on the nurse's progress during the years spent in the IPRP program. There are thus several steps involved before IPRP will confirm that a nurse has successfully completed the program.
- First, the nurse must contact IPRP a month before the completion date on their RMA to confirm that they are in compliance with their RMA, and that IPRP has received all required reports and other documentation
- Second, the nurse must create and submit a detailed “relapse prevention plan” and a “healthy recovery plan” to IPRP
- Third, the nurse must provide written support for the nurse's planned completion of the IPRP program from their therapist, sponsor, and worksite monitor
- Fourth, IPRP will review all of this information and the nurse's IPRP record and may delay the nurse's exit from the program until all required documentation – including drug test results – has been received
Assuming the nurse has successfully met the requirements of their RMA and has submitted all information required by IPRP, then IPRP will send the nurse a successful completion letter. All monitoring and other requirements imposed by the nurse's RMA – including drug testing and employment restrictions – will no longer be in effect.
Challenges of the IPRP Program
Because of the rigorous nature of the IPRP program, there are a number of challenges associated with enrolling that are important to consider before signing an RMA. These include:
- Cost. Participants in Indiana's IPRP are expected to pay for all of their drug testing, medical and psychological evaluations, group meetings, and individual therapy sessions. Total expenses associated with enrolling in what is typically a three- to five-year IPRP program can easily be in the tens of thousands of dollars. While financial support may be available through a Needs Assistance Fund, that support is extremely limited.
- Loss of Employment. Going hand-in-hand with the cost challenge is the fact that a nurse who enrolls in the IPRP must stop working as a nurse until the IPRP agrees to allow them to return.
- Employment Requirements. When the IPRP program approves a nurse's request to return to work, an employer who agrees to hire the nurse must also agree to a number of employment conditions, including assigning a workplace monitor who will submit regular reports about the nurse to the IPRP; limiting the nurse's working hours, shifts, work location, and duties in line with the nurse's and the IPRP's requirements; and understanding that any changes in the nurse's work routine may require advance approval from the IPRP program.
- Travel Restrictions. Travel is more complicated because of the daily check-in requirement and the nurse's obligation to be available for random drug testing on a daily basis.
- Counseling Requirements. The nurse's RMA may require weekly group meetings, AA/NA meetings, and one-on-one therapy sessions, all of which can consume a significant amount of time and, of course, energy.
These challenges, combined with the three- to five-year duration of the IPRP program, may explain why there are so few nurses enrolled in similar programs in other states across the US.
Reasons to Enroll in IPRP
While there are a number of challenges associated with enrolling in Indiana's IPRP program, the same can be said for enrolling in any program that is serious about helping you address a substance abuse disorder. For some people, the rigor and focus of the IPRP program may be what they need to help them overcome their issues with drugs or alcohol. What's important is to be fully informed about what the IPRP program involves before you sign the RMA. That's where the Lento Law Firm Professional License Defense Team can help. We can discuss your situation with you and help you come to an informed decision about what is best for you in your particular situation.
Alternatives to IPRP
Indiana's IPRP is, of course, not the only substance abuse counseling and treatment program out there. There are many programs operated by health care providers, not-for-profit groups, and private clinicians that are designed to help individuals with a wide range of substance abuse issues. It can be very helpful to consider these options before you make a final decision on what's best for you.
Even if the BON has ordered you to contact IPRP as a result of a misconduct complaint that has been filed against you, it may be that you are better off defending yourself against a disciplinary charge than enrolling in IPRP treatment that may not work for you. The Lento Law Firm Professional License Defense Team can help you evaluate your particular situation and decide whether you may be better off defending against the misconduct allegation versus simply committing to a long-term course of monitoring and therapy that may not be right for you.
How the Lento Law Firm Professional License Defense Team Can Help
The Lento Law Firm Professional License Defense Team is made up of attorneys who have years of experience helping nurses across the US – including nurses across Indiana – defend themselves against misconduct allegations. We understand how important your nursing license is to your career, to your well-being, and to your reputation, and our attorneys are ready to help you defend your rights. Whether you're being investigated for alleged misconduct or disciplinary proceedings have been filed against you, we will help you understand what's happening and defend and protect your rights throughout the entire process.
In situations where you've been accused of alcohol or drug abuse, drug diversion, or similar substance abuse-related misconduct, we are here to listen to you and help you consider all of your options – not only the options that the BON may be directing you towards. Deciding whether to enroll in Indiana's IPRP is a big one; the program is intense, will last for at least three years, and will affect your ability to make a living while you're enrolled. Let the Lento Law Firm Professional License Defense Team help you review all of your options so that even if you decide the IPRP is what's best for you, that decision will be based on you making an informed choice.
Call the Lento Law Firm Professional License Defense Team today to tell us about your situation and learn how we can help. You can reach us by phone at 888.535.3686, or you can schedule a confidential consultation by using our contact form. We are here to listen and to help!
