Privatization of Monitoring Programs: Profit Driven Motives

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

The profits being made on nurses forced into monitoring.  Isn't this unethical and potentially illegal? 

I'm trying to do some research on the business side of these agencies that BON'S contract with to do monitoring. The ones that I'm aware of in CA and FL are both "for profit ", and as far as I can tell, have direct financial tires to LabCorp, Soberlink, treatment centers and other providers they require us to pay. It is indeed a form of extortion. 

I'd very much like to open up a dialog on this topic. Everyone outside of nursing, that I talk with, can't believe what we go through, and that someone is making a big profit, even creating incentives for failing and requiring more money forked out. 

There's got to be some accountability here!

 

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People have been saying this for years and nothing seems to ever change. It's insane how much power these people and organizations have.

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I remember looking at so many states. I think Wisconsin is run by the state board. 

This series by MedPage talks about nurse monitoring programs. It touches on the use of subcontractors In NJ.

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

https://www.medpagetoday.com/special-reports/exclusives/93780

https://www.medpagetoday.com/special-reports/exclusives/93876

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These programs are terrifying! Everything is so vague. My up front cost....1850.00...and then 600ishper month. So many more stipulations. Oh and I am not allowed to work until they complete their "investigation". I put myself into a PHP/IOP because I recognized my drinking to be getting out of hand. Never drank or went to work hungover. Then...bam...referral. Now I either figure out how to live and pay them and all the other out of pocket expenses or they will refer me to the BON. It feels like a witch hunt that no matter what I do I am destined to fail. The staff or so uninterested in anything I say. No empathy. No care. Definitely, no support. They just "monitor " us. Oh all this while trying to stay sober and work on my newly discovered PTSD. Yipee! But I should "be lucky" that I was referred to them. Something needs to be done on a federal level. Nurses mental health is clearly a joke to the nursing boards.

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The things that these monitoring programs get away with is staggering to me. I entered the diversion program in California (not by choice) thinking it was going to help me but all it has done has given me PTSD and so much resentment it's unreal. This is not the way to help nurses with addiction problems. 

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I could go on and on about how much of a money scheme the NJ RAMP program is. When I first started our facilitator told us about the most "current research" of nurse monitoring programs throughout the country and said that 3-year monitoring programs appear to be the right amount of time when it comes to completion of the program and relapse rates. But for some reason NJ has to give every single person 5 years. It does not matter what you're being monitored for.... everyone gets 5 years. Why does someone who is in for alcohol addiction have to spend close to $200 every month for DRUG testing? The Peth blood tests are typically done 4-5 times per year (about $138 dollars including collection fee) or if your urine comes back dilute or "abnormal". Speaking of which, the RAMP guide book states: "Dilute urine means that both the specific gravity and the creatinine are above or below normal limits". However according to the NCSBN "Specific gravity between 1.001 and 1.003 with creatinine < 20 is considered DILUTE". So, RAMP believes that a creatinine and specific gravity level that is above normal constitutes a dilute urine. They also state "This may be considered a positive screen". The reason I harp on this is because if you get an "abnormal urine", the follow-up is a $138 Peth test to check for alcohol. I understand the need for follow-up at times but why are they saying your urine is negative but abnormal and then checking for alcohol? Makes no sense. I have spent over $2,300 in one year in drug tests and over $1,300 for an hour Zoom meeting once a week. It amazes me that there is a program for physicians in NJ for monitoring and they have actual physician oversight. Prescriptions are written for the drug tests so you can submit to insurance. We are human beings with legitimate medical conditions that require treatment long-term. But for nurses..... no medical oversight except for nurse case managers who make all the decisions that have a huge impact on your life. The expenses are absolutely ridiculous.

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Sobernurse3263 said:

I could go on and on about how much of a money scheme the NJ RAMP program is. When I first started our facilitator told us about the most "current research" of nurse monitoring programs throughout the country and said that 3-year monitoring programs appear to be the right amount of time when it comes to completion of the program and relapse rates. But for some reason NJ has to give every single person 5 years. It does not matter what you're being monitored for.... everyone gets 5 years. Why does someone who is in for alcohol addiction have to spend close to $200 every month for DRUG testing? The Peth blood tests are typically done 4-5 times per year (about $138 dollars including collection fee) or if your urine comes back dilute or "abnormal". Speaking of which, the RAMP guide book states: "Dilute urine means that both the specific gravity and the creatinine are above or below normal limits". However according to the NCSBN "Specific gravity between 1.001 and 1.003 with creatinine < 20 is considered DILUTE". So, RAMP believes that a creatinine and specific gravity level that is above normal constitutes a dilute urine. They also state "This may be considered a positive screen". The reason I harp on this is because if you get an "abnormal urine", the follow-up is a $138 Peth test to check for alcohol. I understand the need for follow-up at times but why are they saying your urine is negative but abnormal and then checking for alcohol? Makes no sense. I have spent over $2,300 in one year in drug tests and over $1,300 for an hour Zoom meeting once a week. It amazes me that there is a program for physicians in NJ for monitoring and they have actual physician oversight. Prescriptions are written for the drug tests so you can submit to insurance. We are human beings with legitimate medical conditions that require treatment long-term. But for nurses..... no medical oversight except for nurse case managers who make all the decisions that have a huge impact on your life. The expenses are absolutely ridiculous.

This costs me about 15k a year. 3 years. 

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Specializes in Psych, BH, LTC, Rehab, Detox.
Sobernurse3263 said:

I could go on and on about how much of a money scheme the NJ RAMP program is. When I first started our facilitator told us about the most "current research" of nurse monitoring programs throughout the country and said that 3-year monitoring programs appear to be the right amount of time when it comes to completion of the program and relapse rates. But for some reason NJ has to give every single person 5 years. It does not matter what you're being monitored for.... everyone gets 5 years. Why does someone who is in for alcohol addiction have to spend close to $200 every month for DRUG testing? The Peth blood tests are typically done 4-5 times per year (about $138 dollars including collection fee) or if your urine comes back dilute or "abnormal". Speaking of which, the RAMP guide book states: "Dilute urine means that both the specific gravity and the creatinine are above or below normal limits". However according to the NCSBN "Specific gravity between 1.001 and 1.003 with creatinine < 20 is considered DILUTE". So, RAMP believes that a creatinine and specific gravity level that is above normal constitutes a dilute urine. They also state "This may be considered a positive screen". The reason I harp on this is because if you get an "abnormal urine", the follow-up is a $138 Peth test to check for alcohol. I understand the need for follow-up at times but why are they saying your urine is negative but abnormal and then checking for alcohol? Makes no sense. I have spent over $2,300 in one year in drug tests and over $1,300 for an hour Zoom meeting once a week. It amazes me that there is a program for physicians in NJ for monitoring and they have actual physician oversight. Prescriptions are written for the drug tests so you can submit to insurance. We are human beings with legitimate medical conditions that require treatment long-term. But for nurses..... no medical oversight except for nurse case managers who make all the decisions that have a huge impact on your life. The expenses are absolutely ridiculous.

My tech that did my last observed urine test told me that the providers (MD, NP etc) that have to do the drug testing don't have to even do observed urine screens. Unfair! 

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PsychRNXXX said:

My tech that did my last observed urine test told me that the providers (MD, NP etc) that have to do the drug testing don't have to even do observed urine screens. Unfair! 

NJ RAMP does not require observed screening believe it or not 

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Specializes in Psych, BH, LTC, Rehab, Detox.
Sobernurse3263 said:

NJ RAMP does not require observed screening believe it or not 

Interesting. None of these monitoring programs are the same LOL. I don't think I've run across any other people in my state on here. Although a lot of people don't post it in here for privacy reasons and to make sure the BON isn't looking on here LOL 

Healer555 said:

This costs me about 15k a year. 3 years. 

Wow. I wish we could use our insurance for it 😂 I've got Medicaid at the moment so that would be wayyyyy cheaper LOL but I doubt any insurance company would justify paying for it 

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PsychRNXXX said:

My tech that did my last observed urine test told me that the providers (MD, NP etc) that have to do the drug testing don't have to even do observed urine screens. Unfair! 

Where I live anyone with a monitoring agreement does observed urine tests if they can.

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Specializes in Psych, BH, LTC, Rehab, Detox.
Healer555 said:

Where I live anyone with a monitoring agreement does observed urine tests if they can.

Yeh same. All of the urine test are mandatory observed or we'll get in trouble for that. You have to make sure the Lab tech knows to watch you. 

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