Virginia Health Practitioners' Monitoring Program

I am in the writing mood tonight, so I decided to create that post about the Virginia Health Practitioners' Monitoring Program.

I will start by explaining what the Virginia Health Practitioners' Monitoring Program (VA HPMP) is. Most states, not all but most, have a program that monitors what are considered impaired practitioners (i.e. physicians, nurses, pharmacists, counselors, etc.) in order to allow them to still work in their respective field while maintaining safety of the public. VA HPMP is the monitoring program for impaired practitioners in Virginia. It varies state to state what is considered impaired as some states' applications do not ask about mental health. Most states though, including the Department of Health Professions (DHP)-- the department that issues health care professional licenses in Virginia, consider impaired to mean any applicant or licensee with a mental health condition, substance abuse problem, or physical condition that can affect ability to practice. I cannot speak for how or what most of the boards under the DHP ask on their application; however, as a registered nurse, I can attest to the Board of Nursing asking about mental health and substance abuse. It is per self report. That being said, Virginia is a state that requires mandatory reporting of health practitioners going in-patient.

In the event of the Board of Nursing finding out per self reporting; a nurse going in-patient; or an employer reporting a nurse for drug diversion, someone from the Board of Nursing (the Board) contacts that practitioner. After the fact finding, as the Board calls it, is complete, a decision is made about the status of the license of the applicant or licensee through an informal or formal hearing. This decision is out lined in what is called a board order, which includes all the facts of the case and the decision. The applicant or licensee has to sign it before a notary and send the board order back.

If the decision is 'stay of disciplinary action in lieu of entering into the Health Practitioners' Monitoring Program', then the applicant or licensee will have to contact VA HPMP to enroll in the monitoring program. VA HPMP is not run by the Board; the DHP contracts with Virginia Commonwealth University (VCU). The contract length for a participant being in VA HPMP vary, but the most common one I have personally come across is five years. Once enrolled into VA HPMP, one would have to attend orientation for the monitoring program. All orientations are held in Richmond. During orientation, a participant meets their case manager; is given their first contract; and attends a presentation on what is expected of the participant. The typical contract usually includes drug screens at the participant's expense; AA/NA meetings; Caduceus meetings (support meetings specifically for healthcare providers); and monthly forms being filled out from the participant, their therapist, any and all physicians seen during that month; and their work site monitor (once approved to work). During the first three to four months in the VA HPMP, the participant is not allowed to practice. Once given approval to job search, certain stipulations are given (i.e. no working home health, no night shift, no giving narcotics or controlled substance for a certain time frame). If a participant finds a job, the position is staffed for approval or denial of accepting said position. In addition, if a participant finds a job in a different state than Virginia, then a request to accept the position has to be sent to Executive Director of both Virginia and the other state as the participant loses their compact license privileges while in VA HPMP.  Once the position is approved, a new contract in VA HPMP is created (not to be confused with a board order, which is not controlled by VA HPMP, and nothing can be changed about them). The participant has to give a copy to everyone involved--therapist, work site monitor, have a copy for themselves. The process of receiving a new contract occurs every time there is any change in a contract.

I do not exactly know where to include this, so I will explain it in a separate paragraph. Affinity does the drug screen compliance for VA HPMP. The participant either calls a number or checks in online Monday-Friday to find out if they are tested that day. If they are tested, the participant selects a testing site and pays for the drug screen online or via phone. The cost usually ranges from $30s-$50s, sometimes more depending on the site fee. Then, they go to the site and do the urine drug screen. If it is anywhere other than LabCorp, then a chain of custody has to filled out and given to the site to send in with the drug screen. If it is LabCorp, LabCorp usually receives a fax with the information. I usually bring a chain of custody form with me in case LabCorp's computer is down and they can not receive the fax or print the information they need.  Assuming the participant is not using drugs; dehydrated; or overhydrated, the screen should be negative. The participant does not receive any notification of the result unless the screen is abnormal or positive. An abnormal comes from either too concentrated (dehydration) of a specimen or too dilute (overhydration), intentional or non-intentional. If an abnormal occurs, then usually the next drug screen is a blood test. I personally have had several too concentrated specimens and have been sent for blood test drug screens. They are very expensive, around $140, so my next drug screens are going to be observed urine drug screens. Observed urine drug screens are more expensive than non observed urine drug screens but less expensive than blood test drug screens.

That is the gist of the VA HPMP. I do not know what happens at the end of the contract as I still have a yr and a half left in VA HPMP. I will update once I know.

Hope this helped anyone not familiar with the VA HPMP or anyone getting ready to enter into a contract with them.