Problems with monitoring agency follwing rules?

[1sttime]

Hi all,

I was wondering if anyone else had had problems with their monitoring agency following the protocols they have set.

I have had a few issues so far and I've only been in the program a couple of months...

1) The testing exemption policy is that if you have been in a treatment program when you enroll in monitoring that time will be included in your plan participation. You can request an exemption after 9 months of being compliant- which I have throughout treatment and monitoring. My mother in law was just diagnosed with stage 4 breast cancer- this Christmas might be her last; she lives in a very remote location (nearest testing facility is 60 miles away). In winter this 60 miles can take 3-4 hours to get to because of road conditions. My agreement monitor is stating that I have to be in monitoring for 9 months before an exemption can be granted (a direct conflict with the contract language).

2) The monitoring agency is to not diagnose or treat. I had an independent evaluation from an approved 3rd party. I have not heard from him, I asked my agreement monitor about this and she stated the medical director and evaluator were working to come to an agreement on some of his recommendations. The fact that they are discussing treatment recommendations seems to me like they are participating in the treatment plan.

3) The monitoring agency is not funded by wholly by the state board- I am charged over $100 for each UA. My neighbor state runs their own monitoring and charges $50 for the same panel. The testing frequency for the first 2 years is supposed to be 24-36 times- I am on track at this point to being tested more than 52 times (at least once per week, sometimes 3 times in a week). I feel like they have a financial interest in testing me more frequently.

I have not had any instances of non-compliance, no dilute urines, missed calls, or anything that isnt 100% above board. I see no reason that they are not following the protocols set by the legislature and BON.

Has anyone else had problems like this? What did you do or would you do to remedy these types of issues?

[wish_me_luck, BSN, RN]

I don't exactly see where they are not following the rules. You have been in 2 months. You can't get an exemption until 9 months. Hence why you were denied. Tx is not actual tx, more like you go to this many meetings (12 step or nurse/Caduceus) and you have to go visit a provider x times. It's like a compliance plan. The cost, well, it is expensive. I don't know what to tell you about that. Are you allowed to find a nursing job now?

Sorry.

PS Are you sure your tx (rehab?) time counts?

[SouthernPoint]

Every states monitoring program is different in some way. Where are you located? That might help and maybe someone from your state can help point you in the correct direction.

I am in Florida and you are allowed to travel. It can be for a death in the family, a vacation, to visit someone sick or just because. All we have to do is contact our case worker and put in for a monitoring interruption request. I have never been told I couldn't go anywhere. I have been on cruises (which went out of country) and I have gone out of my state many times. They only thing I have to do is if I am in the states I do have to check in via computer or phone Monday thru Friday. If I am selected, I just let them know where I was and I get a receipt or something from the area I am in with the date/time/location. I have never had a problem.

As for the drug screens. In Florida are screens run around $42.00. I have had months where I only go once. I have had months where I go twice and I have had months where I go three times and in that month I went twice in one week. It's totally random so-to say.

In all honestly the best person to speak with would be your case worker. Explain to them what you have told us and see where it goes..

Please keep us updated. Wishing you the best of luck and prayers to your mother in law.

SP

[1sttime]

Hi all,

Here is an update:

So after pressing the issue I am able to get exemption time from testing; so far I havent had or wanted to use it- but yes the time in treatmentis supposed to count towards this exemption policy.

I am still being tested at least one time per week. The program states 24-36 times per year the first year- I am on track to being tested more than 52 times this year. My monitoring entity does not receive money from the state and relies on the $106 per test for funding.

The difficulty I am having with this is the fact that this disease is shrouded in such secrecy; plus many of us in the program have made it their identity to such an extent that the advice I am given is to suck it up. I agree to some extent... yes its better than jail, or losing the ability to practice all together- however we all know what happens if any type of patient is overtreated. Too much of any medicine is worse than the underlying disease.

I have had several instances where I believe the program is not acting ethically and is treating me like a cash cow.

1) The rules specifically prohibit the treatment provider from being the prescriber of treatment; this has not been followed and therefore I have been in treatment longer. The last time I had an "independent" evaluation I was told that the reason for delay in the evalutors report is that the medical director of the program and evaluator were discussing the recommendations to be set.

2) The more times I am tested the more money the program gets. I have had no issues of non-compliance.

3) Nurses who decide to take a reprimand (ie have their names printed as drug addicts) are in the program for 2 years vs 4-5 years. Do the nurses who choose discipline have a different disease than me? Why would it be ok to have less time being monitored?

All I have been advocating for is fairness in following rules and evidence based practice when it comes to treatment.