Kentucky Administrative Regulations
Title 201 - GENERAL GOVERNMENT CABINET
Chapter 20 - Board of Nursing
Section 201 KAR 20:450 - Alternative program
Universal Citation: 201 KY Admin Regs Service 20:450
Current through Register Vol. 51, No. 3, September 1, 2024
RELATES TO: KRS 314.085, 314.091, 314.171, 314.470,
NECESSITY, FUNCTION AND CONFORMITY: KRS 314.131(1) authorizes the Board of Nursing to promulgate administrative regulations as may be necessary to enable it to carry into effect the provisions of KRS Chapter 314. KRS 314.171 authorizes the board to establish an alternative to discipline program to promote early identification, intervention, treatment, and rehabilitation of nurses who may be impaired by reason of illness, alcohol or drug abuse, or as a result of any physical or mental condition. This administrative regulation provides procedures for the implementation of an alternative program.
Section 1. Definitions.
(1) "Approved
treatment provider" means an alcohol or drug treatment provider that meets the
standards as established in Section 7 of this administrative
regulation.
(2) "Board" means the
Board of Nursing.
(3) "Program"
means the Kentucky Alternative Recovery Effort for Nurses which is the
alternative program operated by the board for nurses.
(4) "Substance use disorder" means the
combined DSM-IV categories of substance abuse and substance
dependence.
Section 2. Admission and Denial to the Program.
(1) In
order to gain admission to the program, an individual shall:
(a) Be an advanced practice registered nurse,
a registered nurse, or a licensed practical nurse licensed in the Commonwealth
of Kentucky, a holder of a multistate licensure privilege pursuant to
KRS 314.470, or an
applicant for a credential issued by the board;
(b) Request in writing participation in the
program;
(c) Admit in writing to
having a substance use disorder;
(d) Agree in writing to the terms established
in the program agreement;
(e)
Obtain a current substance use disorder assessment, which may include a
complete physical and psychosocial evaluation performed by a licensed or
certified medical, mental health or psychological specialist in the field of
drug, alcohol, or other substance use disorder;
(f) Provide any evaluation and treatment
information, disclosure authorizations, and releases of liability as may be
requested by the program staff;
(g)
Agree to abide by the program staff's finding regarding employment as a nurse
pending admission; and
(h) Have
attended or be enrolled in an approved treatment provider program.
(2) Admission to the program shall
be denied if the applicant:
(a) Does not meet
the eligibility requirements for admission as established in subsection (1) of
this section; or
(b) Is not
eligible for licensure in Kentucky or if the board does not grant authorization
to practice under
KRS 314.470 Article V(f)
or
201 KAR
20:500, Section 3(2).
(3) Admission to the program may be denied if
the applicant:
(a) Diverted scheduled
substances for other than self-administration;
(b) Will not substantially benefit from
participation in the program;
(c)
Has a criminal conviction related to the sale or distribution of scheduled
substances or legend prescription drugs; or
(d) Has been terminated from alternative
program participation in Kentucky or any other state.
(4) In the case of an applicant for a
credential issued by the board, admission to the program shall be conditioned
upon obtaining licensure in Kentucky. Failure to obtain licensure shall result
in denial of admission to the program.
Section 3. Requirements for Participation in the Program.
(1) A participant shall:
(a) Enter into a program agreement;
and
(b) Comply with all of the
terms and conditions of the program agreement for the time period specified in
the agreement.
(2) The
program agreement may include any of the following:
(a) A requirement that the participant
undergo and successfully complete substance use disorder treatment by an
approved treatment provider;
(b) A
requirement that the participant agree not to practice in any capacity in a
patient care setting or area which requires licensure until approved to do so
by the program;
(c) A requirement
that the participant undergo and successfully complete the continuing care
program recommended by the approved treatment provider and designated in the
program agreement. The continuing care program may include individual or group
counseling or psychotherapy;
(d) A
requirement that the participant remain free of alcohol, mood-altering
substances including herbal preparations, over-the-counter medications
containing alcohol or mood-altering substances, and any other medication except
for substances prescribed by a practitioner authorized by law to prescribe for
a specific medical condition;
(e) A
requirement that the participant inform all treating health care practitioners
of the participant's substance use disorder and recovery status prior to
receiving a prescription for any medication, mood-altering substance, or herbal
preparation;
(f) A requirement, if
a participant shall take any substance prescribed or recommended by a
practitioner, that the participant provide the program written documentation
from the practitioner that the use of the substance does not impair the
participant's ability to practice nursing in a safe and effective manner and
will not interfere with the participant's recovery program provided the
substance is used in accordance with the prescription or
recommendation;
(g) A requirement
that if the participant is prescribed, recommended, or dispensed any medication
by a practitioner, the participant shall cause the practitioner to report the
medication to the program. The report shall include the diagnosis, the name of
the medication, the quantity prescribed, any refills or any other information
about the medication requested by the program staff, and shall be submitted to
the program within the time specified in the program agreement. Consultation
with a physician addictionologist may be required by the program and the
participant shall agree to abide by any finding made by the physician
addictionologist;
(h) A requirement
that the participant cause all treatment providers and counselors to provide
any reports as may be required by the program at the intervals specified in the
program agreement;
(i) A
requirement that the participant submit to random alcohol and drug testing when
requested by the program, and that the participant comply with all requirements
of the program concerning random alcohol and drug testing;
(j) A requirement that the participant attend
twelve (12) step group meetings, or other group meetings as specified by the
program agreement, and that the participant verify attendance at these meetings
by signature of a group or meeting representative and submit the signatures to
the program;
(k) A requirement that
the participant comply with the employment and nursing practice restrictions
specified by the program agreement;
(l) A requirement that the participant sign a
waiver which may allow the program to communicate with the participant's
treatment providers, counselors, employers, work site monitors, law enforcement
officials, and support group facilitators, if applicable;
(m) A requirement that the participant be
responsible for paying the costs of the physical and psychosocial assessment,
substance use disorder treatment, and random alcohol and drug testing, or any
other costs incurred in complying with the program agreement;
(n) A requirement that the participant submit
a written personal report to the program at the intervals specified by the
program agreement;
(o) A
requirement that the participant meet in person with a program representative
at the intervals specified by the program agreement;
(p) A requirement that the participant shall
not work as a nurse in another Nurse Licensure Compact state without the
permission of this state and the other state; and
(q) A requirement that the participant comply
with all other terms and conditions specified in the program agreement which
the program staff finds are necessary to ensure that the participant is able to
practice nursing in accordance with acceptable and prevailing standards of safe
nursing care.
Section 4. Successful Completion of the Program.
(1) A participant successfully completes the
program when the participant fully complies with all of the terms of the
program agreement for the period as specified in the agreement.
(2) When a participant successfully completes
the program, the program shall notify the participant of the successful
completion in writing. Once the participant receives this written notification
of successful completion of the program, the participant shall no longer be
required to comply with the program agreement.
(3) A participant who successfully completes
the program shall not be reported to the National Council of State Boards of
Nursing's disciplinary data bank.
Section 5. Causes for Termination from the Program. A participant may be terminated from the program for the following causes:
(1) Noncompliance with any aspect of
the program agreement; or
(2) Being
unable to practice according to acceptable and prevailing standards of safe
nursing care.
Section 6. Resignation From the Program.
(1) A
participant may resign from the program.
(2) Upon resignation, the participant shall
sign an agreed order in conformity to
201 KAR
20:161, Section 2(4) voluntarily surrendering the
nursing license.
Section 7. Standards for Approved Treatment Providers. In order to be an approved treatment provider, the treatment provider shall:
(1) Be:
(a)
Accredited by the Joint Commission for the Accreditation of Healthcare
Organizations or be state-certified and shall have operated as a substance use
disorder treatment program for a minimum of one (1) year; or
(b) A licensed or certified specialist in the
field of substance use disorder treatment as outlined in
201 KAR
20:163, Section 2(2);
(2) Provide inpatient or outpatient
care;
(3) Be based on a twelve (12)
step program of Alcoholics Anonymous, Narcotics Anonymous, or an equivalent
support group;
(4) Provide
development of an individualized treatment and aftercare program to meet the
specific needs of the participant and make recommendations regarding an ongoing
rehabilitation plan;
(5) Be based
on an evaluation that meets the standards of
201 KAR
20:163, Section 3;
(6) Provide clearly-stated costs and fees for
services, and offer fee schedules and flexibility in payment plans to
accommodate participants who are underinsured or experiencing financial
difficulties;
(7) Demonstrate
willingness to provide information to the alternative program regarding the
status of the participant after applicable consents to release information are
obtained;
(8) Work closely with the
alternative program staff to assure proper implementation and administration of
policies and procedures related to the program;
(9) Maintain timely and accurate
communication with program staff, including assessments, diagnosis, prognosis,
discharge summary, and follow-up recommendations as well as reports on
significant events which occur in treatment that are related to impairment and
the ability to practice safely; and
(10) Provide written reports of progress at
intervals as requested by program staff.
Section 8. An individual who is admitted to the program but does not hold a Kentucky nursing license shall pay a participation fee of fifty (50) dollars per year.
Section 9.
(1) A participant in the alternative program
who moves to another jurisdiction may transfer to the new jurisdiction's
alternative program.
(2) If the
participant is accepted into the new jurisdiction's alternative program, the
participant may relinquish his or her Kentucky license pursuant to
201
KAR 20:510.
(3) The provisions of Section 6 of this
administrative regulation shall not apply in this situation.
(4) If the participant relinquishes his or
her Kentucky license, the alternative program in Kentucky shall cease
monitoring the participant.
STATUTORY AUTHORITY: KRS 314.131(1), (2), 314.171(3)
Disclaimer: These regulations may not be the most recent version. Kentucky may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.
