NJ RAMP

IrishCMSRN, BSN, RN · Aug 7, 2021

ughhhhhh.....call an attorney who specializes in medical licensing. Once you get sucked into RAMP it will follow you and your license forever. I made the same mistake in PA. Trust me, talk to an attorney before going to any evaluation. The "board" is NOT your friend.

lizzienj · Sep 13, 2021

I was referred to RAMP under similar circumstances, so I'll tell you my experience and hopefully you'll find it helpful. I got a DUI prior to becoming a nurse, prior to applying to nursing school even. RAMP starts off with an initial "phone interview" where you basically have to detail any and all substances you've ever used/abused, any mental health issues you've experienced, etc. Followed by you signing up for mandatory "support group" meetings and submitting to random drug testing. IIRC they tell you you'll be evaluated by one of their therapists after you have been in the program with x number of clean drug tests. They tell you that if the therapist recommends you receive treatment, you'll be offered a 5-year contract to stay in RAMP. If you accept, you'll receive your license, if you don't, the board denies your licensure, but in reality, it seems to just depend on the whim of whichever person you get assigned as your case manager. My evaluator told me she was recommending I be discharged since I had one DUI years ago and no history of substance abuse issues or other deliquency. RAMP told me after reviewing her input I was being offered a two-year contract for "mental health" because I had honestly answered that I was taking Prozac prescribed by my doctor for depression, and this meant I was as unsafe to practice an in need of monitoring as someone in active addiction who had been caught diverting drugs, apparently. It doesn't make any sense. There were people in my "orientation" support group with the exact same charge (DUI prior to licensure) who were discharged and granted their licenses and allowed to practice freely. But like I said, it seems to depend on the whims of the RAMP employees who gets "treatment" and who doesn't.

As far as there being "tiers," unofficially as RAMP doesn't outright say this, it seems that if you have substance abuse issues or have otherwise misused your nursing license (for example, I've seen people who got 5 years for lying about the dates of their CEUs) you get offered a 5-year contract. If you can "pin" the issue that got you into trouble with the board on any sort of mental health issue, you may be offered a "mental health" contract which is 2-years long with the exact same terms. However during all this time that they are "evaluating" you, you will not be granted your license, will not be allowed to work, and both RAMP and the BON it seems intentionally drag their feet on getting you your license. For example, I was first referred to RAMP in September of 2019, RAMP did not give me a decision about my evaluation until March of 2020, and the BON did not grant me my license until June 2020. And I've heard of people waiting much longer.

I saw another response to your post recommending you get an attorney, but I don't recommend that. Everyone I've met that got an attorney involved or tried to fight RAMP got nowhere and instead ended up starting the program way later, now with the addition of thousands of dollars in lawyer fees to pay. The BON totally endorses RAMP as an alternative to discipline, so there is no other option. There's no legal battle to fight, much less win. I'll link the RAMP guidebook, it outlines all of the rules and restrictions you'll face as a nurse practicing while in RAMP so you can get an idea of what you're potentially facing.

I kinda feel like this was off the rails from your original question but when I was in your place I wished I knew what was coming from someone with the same perspective as me. Everyone else seemed to have major legal issues and substance abuse issues, mostly either showing up to work high or diverting drugs. Based on a DUI 20 years ago I'd say there's a decent chance they'd let you go, however a recent public intoxication charge makes me think you're likely to be told you need monitoring. But as I said, it's hard to predict because people in two identical situations will be treated totally differently. And vice versa, once you're in, regardless of what brought you to RAMP you're all treated exactly the same. Hard and fast rules and strict restrictions on your nursing practice with no exceptions. Basically, if you're working in a different state with no issues, I'd avoid NJ altogether. Once RAMP gets involved they'll notify or require you to notify the BON in any other states in which you are licensed. IMO, it's not worth it.

https://njsna.org/wp-content/uploads/2021/03/final-2021_ramp_participant_guide-revisions-2-25-21.pdf

Jewel812 · Oct 14, 2021

On 8/1/2021 at 6:58 PM, newguy0101 said:

How does evaluation work?

I have been asked to enroll in the RAMP program for an evaluation prior to RN licensure. Once evaluated and supported by RAMP for licensure, my application can proceed through the approval process.

So how will this work? I have an alcohol related arrest without conviction 20+ years ago and a recent ticket for public intoxication. This is why the board is recommending enrollment and evaluation.

Are there levels of enrollment? Will I be required to do 5 years of drug testing, therapy, group sessions for a drunk in public ticket? Maybe required to do a lighter version of the program?

Will I be suspended from working once enrolled? This is my biggest fear. How will it impact my licensure in a near-by state where I live and work? I have been upfront with all required disclosures with my BON and am successfully working at a local hospital. Will enrolling in RAMP at all jeopardize any other nursing licenses?

This NJ license is a ‘nice to have’ not ‘need to have’ kind of thing in case an attractive job across the state line opens up. Is it worth subjecting myself to this program for this additional license?

Whatever happened? Once they said you had to do ramp did you just go to another state? Did that affect your other licenses?

Hard knocks09 · Oct 2, 2022

Its just a way to dangle your career over your had while costing exorbitant amounts of money. I was promised to return to work in August last year, then October, then January. I was more emotionally scarred from the process than what I was there for. They just kept jerking my life around and after 3 years I quit because I needed to put myself first. I want to go back into it and restore my license but the same people are running it.

Nurse_MSNRN · Mar 5, 2023

lizzienj said:

I was referred to RAMP under similar circumstances, so I'll tell you my experience and hopefully you'll find it helpful. I got a DUI prior to becoming a nurse, prior to applying to nursing school even. RAMP starts off with an initial "phone interview" where you basically have to detail any and all substances you've ever used/abused, any mental health issues you've experienced, etc. Followed by you signing up for mandatory "support group" meetings and submitting to random drug testing. IIRC they tell you you'll be evaluated by one of their therapists after you have been in the program with x number of clean drug tests. They tell you that if the therapist recommends you receive treatment, you'll be offered a 5-year contract to stay in RAMP. If you accept, you'll receive your license, if you don't, the board denies your licensure, but in reality, it seems to just depend on the whim of whichever person you get assigned as your case manager. My evaluator told me she was recommending I be discharged since I had one DUI years ago and no history of substance abuse issues or other deliquency. RAMP told me after reviewing her input I was being offered a two-year contract for "mental health" because I had honestly answered that I was taking Prozac prescribed by my doctor for depression, and this meant I was as unsafe to practice an in need of monitoring as someone in active addiction who had been caught diverting drugs, apparently. It doesn't make any sense. There were people in my "orientation" support group with the exact same charge (DUI prior to licensure) who were discharged and granted their licenses and allowed to practice freely. But like I said, it seems to depend on the whims of the RAMP employees who gets "treatment" and who doesn't.

As far as there being "tiers," unofficially as RAMP doesn't outright say this, it seems that if you have substance abuse issues or have otherwise misused your nursing license (for example, I've seen people who got 5 years for lying about the dates of their CEUs) you get offered a 5-year contract. If you can "pin" the issue that got you into trouble with the board on any sort of mental health issue, you may be offered a "mental health" contract which is 2-years long with the exact same terms. However during all this time that they are "evaluating" you, you will not be granted your license, will not be allowed to work, and both RAMP and the BON it seems intentionally drag their feet on getting you your license. For example, I was first referred to RAMP in September of 2019, RAMP did not give me a decision about my evaluation until March of 2020, and the BON did not grant me my license until June 2020. And I've heard of people waiting much longer.

I saw another response to your post recommending you get an attorney, but I don't recommend that. Everyone I've met that got an attorney involved or tried to fight RAMP got nowhere and instead ended up starting the program way later, now with the addition of thousands of dollars in lawyer fees to pay. The BON totally endorses RAMP as an alternative to discipline, so there is no other option. There's no legal battle to fight, much less win. I'll link the RAMP guidebook, it outlines all of the rules and restrictions you'll face as a nurse practicing while in RAMP so you can get an idea of what you're potentially facing.

I kinda feel like this was off the rails from your original question but when I was in your place I wished I knew what was coming from someone with the same perspective as me. Everyone else seemed to have major legal issues and substance abuse issues, mostly either showing up to work high or diverting drugs. Based on a DUI 20 years ago I'd say there's a decent chance they'd let you go, however a recent public intoxication charge makes me think you're likely to be told you need monitoring. But as I said, it's hard to predict because people in two identical situations will be treated totally differently. And vice versa, once you're in, regardless of what brought you to RAMP you're all treated exactly the same. Hard and fast rules and strict restrictions on your nursing practice with no exceptions. Basically, if you're working in a different state with no issues, I'd avoid NJ altogether. Once RAMP gets involved they'll notify or require you to notify the BON in any other states in which you are licensed. IMO, it's not worth it.

https://njsna.org/wp-content/uploads/2021/03/final-2021_ramp_participant_guide-revisions-2-25-21.pdf

your response was very informative. Once they meet on that Thursday do they discharge you quickly from the program even if it's before 90 days or no?

Dddd · Jun 14, 2023

Its a complete violation of rights and freedom. How is that no one has been able to sue ramp of BON and not win.. It's disgusting. They ruined my life for a dui that had nothing to do with my job.. I just don't undeastand how they are allowed to do that. I have a child and no means to support us

Hard knocks09 · Jun 15, 2023

I have total PTSD from my situation. I had to limit where and what times I could work around random tests, meetings.......being berated on a weekly basis and 0 support or feeling uplifted or hopeful. I ended up homeless during covid. I have 20 years experience and barely making over minimum wage at the moment. I miss my vocation. I miss helping people. A good team. Feeling accomplished at the end of the day. Now I feel like a failure.

dancinginthedark · Aug 29

I want to add that since this post was made, two year contracts are increasingly rare. It's mainly 5 year contracts. My case manager mentioned that even if you have a decade old DUI, it's like 90% will get a contract. If you have old dui + documented mental health disorder, definitely getting 5 years (one nurse had eval that said she didn't need monitoring but still got 5 years). In which case, it seems like an awful waste of money to spend $$$ on evaluations that are immaterial.

Hard knocks09 · Aug 29

dancinginthedark said:

I want to add that since this post was made, two year contracts are increasingly rare. It's mainly 5 year contracts. My case manager mentioned that even if you have a decade old DUI, it's like 90% will get a contract. If you have old dui + documented mental health disorder, definitely getting 5 years (one nurse had eval that said she didn't need monitoring but still got 5 years). In which case, it seems like an awful waste of money to spend $$$ on evaluations that are immaterial.

I wholly feel this. It's absolutely a racket for money. You want to stay employed or ever get reemployed? Jump through these expensive flaming hoops. We don't care if you lose everything in the process. You did this to yourself. Make this a priority. 🤦🏼‍♀️. I'm not the only one who quit out of mental duress. 3 others quit after me and one I know is STILL in therapy for the "help" they were trying to provide her.

dancinginthedark · Sep 8

Hard knocks09 said:

I wholly feel this. It's absolutely a racket for money. You want to stay employed or ever get reemployed? Jump through these expensive flaming hoops. We don't care if you lose everything in the process. You did this to yourself. Make this a priority. 🤦🏼‍♀️. I'm not the only one who quit out of mental duress. 3 others quit after me and one I know is STILL in therapy for the "help" they were trying to provide her.

There was an investigative article about RAMP. I remember the case manager mentioned that the collection site fees are a new thing that was introduced during covid. I think the subcontractors and evaluators are trying to make money of course, but I don't think the board is intentionally trying to run a racket. The thing is that general trend since 80s to deprive the state of money through tax cuts, so it's not as if there is a pot of gold sitting around to cover the cost of these programs.

https://www.medpagetoday.com/special-reports/exclusives/93779

Another aspect is the way that the state tends to take a punitive stance overall, even when it's allegedly designed to help participants. When I explained RAMP to my therapist, he noted that it's very similar to probation. He explained how his patients who are in probation have rather stringent requirements that are designed to make it as frustrating as possible. And if they fail to meet these requirements, it is deemed as some kind of personal failure.

I think where it gets frustrating is the conflicting message about this program being designed to help. On the one hand, it does allow you to avoid suspension and public order. On the other hand, it is still punitive. For the board, it is a win-win. If you fail to meet the requirements, then you can't work as a nurse. If you successfully complete program, then it ensures public safety.

The main issue I have is that there is no gradual loosening of restrictions. To me, it would make more sense if the restrictions were lifted over time so you can practice as you normally would. And the board can see that you will be safe to practice without monitoring. Because if working overtime or night shift or whatever is a risk factor for relapse or whatever, then let people work overtime while in monitoring.

I find it is less upsetting just to think I am doing this to prove I am safe to practice vs this is meant to help me.

NURSE72ik, LPN, RN · Sep 30

This program ruined my life. Thanks (MODERATOR EDIT OF NAMES - PLEASE DO NOT POST NAMES/IDENTIFYING INFO ABOUT OTHERS PER THE TERMS OF SERVICE) with the BON. RAMP is only about money, not your wellbeing, nor that of patients. They withhold your license, force you to pay for affinity while not allowing you to make money to pay for it. I've seen so many people give up, including myself. I was enrolled, got pregnant with my daughter, had to go on leave r/t complicatoons( then they wanted to start me over.... Twice. Can't afford it. The most evil program I've heard of, prison is less harsh than RAMP. Oh, god forbid you take medications that help you, non narcs? You're screwed