CA Diversion Program Changes

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Specializes in ER.

The recent CA BRN changes have been increasingly mentioned in public comments at BRN meetings.  What the heck am I referring to?

The CA BRN diversion program has recently made changes to their rules on nurse participants without warning or explanation.  If you are currently on diversion (formerly known as intervention) this will affect you.

In recent BRN meetings, which are generally open to the public, portions are closed to the public for confidentiality reasons, nurses, lawyers and BRN support group moderators have been speaking out about changes to the diversion program. 

Nurses who were months, weeks or days away from completing their diversion programs are being told that they must work a minimum of 6 months passing narcotics before they will be considered safe to complete the program.  Before this recent rule change which purportedly began around December, nurses in early 2023 were informed that THEY would not be released from the diversion program unless they worked a minimum of 6 months in an approved RN role.  

Many nurses joined the Diversion program prior to November 2023 when these rules were not in effect.  These nurses were not grandfathered into their contracts and many nurses were presented new contracts with no options but to accept the new terms of the BRN's contract or risk immediate removal from the program and start at the beginning of a probation process after months or years of compliance with the diversion program run by Maximus. 

If you are currently in diversion, or you have previously completed the diversion program, please watch the archived BRN meetings since December. 

The archived meetings can be accessed at https://www.RN.ca.gov/consumers/webcasts.shtml.

I highly suggest you watch the BRN meeting on February 28.  There were many complaints brought up with the nursing board. 

You can find the dates of upcoming BRN meetings at https://www.RN.ca.gov/consumers/meetings.shtml#boardcomm.

This issue will tentatively be an agenda line item discussed at the May BRN meeting. 

The public is allowed to attend all open sessions of BRN meetings. 

Please share this in your BRN Nursing Support groups and encourage every diversion nurse and support group moderator you know to attend future meetings.

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Specializes in Mental health, Critical Care, Nurse Educator du.

Can someone provide clarification on what the "diversion" program is? I'm very confused by the terminology when it comes to CA's programs. Which one is run by Maximus? 

How are the programs different? If you've not been disciplined, but have gone into a program voluntarily, is it a diversion program? I  can't find this information on the BRN website.

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Specializes in ER.
Quickstepper said:

Can someone provide clarification on what the "diversion" program is? I'm very confused by the terminology when it comes to CA's programs. Which one is run by Maximus? 

How are the programs different? If you've not been disciplined, but have gone into a program voluntarily, is it a diversion program? I  can't find this information on the BRN website.

Diversion AKA Intervention AKA Alternative to Discipline

This is the program a nurse can volunteer to join. The main benefit is you do not have a public record of an administrative charge against your license such as alcohol use disorder, a mental illness or drug use disorder.  You can not work for at least a year and must undergo inpatient or outpatient hospitalization and anywhere from 52-150 mandated random drug tests a year.  You have a case manager and restrictions and actions you must follow in order to keep your anonymity and complete the program. They make you sign a contract but the BRN does not have to sign the contract and can make changes anytime they wish.  There is no requirement for the board to release you in a timely manner, however they say you will remain in diversion until they release you for 3-5 years. You must work a minimum of 6 months with narcotics to be released from diversion. The BRN stated this requirement is proposed, however it is currently being imposed, with no warning to nurses who had as little as one day to be released. 

Probation is run by the DA but the BRN ultimately decides what charges will be levied and what restrictions will affect your license.  It can also include inpatient or outpatient hospitalization, random drug charges, a fine up to $20,000, and you must work or your license gets suspended.  It is a public administrative charge against your license that will remain publicly accessible online for 10 years. After 10 years, the complaint is no longer available online however, a flag will be noted on you license that a previous action was placed on your license and you can call the BRN to access anyone's complaint after 10 years so it will always be available publicly.  The probation period has a legally binding term end date if you follow all the requirements listed.  The BRN does not have to follow the judge or DA's recommendation and can choose what ultimately happens to the nurse. 

Hope this helps explain the differences. 

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Yep. I'm one of the unfortunate nurse affected by this change. Was supposed to be done in April 

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This is wild. I almost understand but I have no desire to ever work around narcotics again? I don't think 6 months would make it any safer for me? My job in monitoring had no narcotics so I would have been SOL.

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Yeah it's completely ridiculous. I'm so bummed out about it. I've had a counter on my phone for the last over 3 years and now when I get out is suspended indefinitely. Keep in mind I've been 100% compliant during this time 

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There is another BRN meeting to discuss narcotic access and work requirements on June 21, 2024. I recommend everyone attend and speak out during the public comment portion. Pass this along to other nurses who are concerned about the changes. 

Below is the link to meeting agenda:

https://RN.ca.gov/pdfs/meetings/brd/brdagenda2_jun24.pdf

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Specializes in ER.

This is absolute insanity!  [MODERATOR EDIT OF NAME, PER TOS] must be removed or reassigned. 

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Specializes in ER.
Erin1984 said:

Yeah it's completely ridiculous. I'm so bummed out about it. I've had a counter on my phone for the last over 3 years and now when I get out is suspended indefinitely. Keep in mind I've been 100% compliant during this time 

This is so heartbreaking!  Report the BRN to the state Auditor, send letters to local state representatives and senators.  They are starting to hear us roar. We would never allow a patient to be abused. I refuse to see nurses be abused so callously!

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I agree with you all above regarding nurse boards overstretched and siding more with being far to punitive instead of truly just protecting the public. But, 2 things here.

First, anyone who has done their timen should be grandfathered in and the new rule should NOT be allowed to effect those already in the program. What the California Board is doing to these nurses is WRONG, period. Here is the issue most savvy Boards write in the consent order and it's  something related to the fact that they can increase or decrease requirements as they see fit and the nurse signs it. This greatly hurts a nurses legal chances to fight back. I would STILL get an attorney and fight this if in this situation.

Second. What the California BON is doing overall by having the 6 months narcotic restriction in place is RIGHT, as it relates to nurses who have not entered the program yet or about to enter it. Why? Because the DATA says so. BONs in today's time (not all but the overwhelming majority of them) are driving their decisions based on research data for recovery/addiction/public safety/chances of relapse. They aren't just shooting from the hip drinking coffee one morning and someone says," I have an idea, let's do this or that". They are getting research data from recovery experts that guide these decisions. Check this out, California is actually being somewhat Lenient with 6 months. About one half of all states now have a 1 year restriction on narcotics/passing narcs for nurses who are in the program who diverted or where addicted to opiates and have confirmed SUD for narcotics. In 2 years, you can't bet all 50 states will AT THE VERY least, have a 6 month restriction and most of them will be 1 year. Why? Research shows that a nurse is Far less likely to divert or reuse if they have a 1 yr narc restriction when returning to practice and far less likely to divert/relapse/reuse 2 or 3 or 4 years or 5 years later if they undergo a 1 year narc restriction when returning to practice. The Data is very clear on this and it's why California and most states are going to this.

But....for the people already in California's program and doing this to them, it's WRONG and not OK and California should be called out on it.

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The person you are talking about is awful and a liar. If you listen to her in the BRN meetings she just spouts falsehoods and the BRN believes her. I had my DEC last Thursday and she was actually in my meeting! I was like why is the head of probation in my Dec?! There is something nefarious going on and I hope they remove that woman 

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The program has become a perfect example of abuse of power.  Let's do it!

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