Privatization of Monitoring Programs: Profit Driven Motives

[Quickstepper]

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!

 

[Sobernurse3263]

AnonMiscRN said:

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.

One of the most annoying things is for people like myself who are in there for alcohol issues... most of your expense for testing is checking for drugs. So I spend a minimum of $200 per month on drug tests when I never even used them and was referred for alcohol...

[PsychRNXXX, BSN]

Sobernurse3263 said:

One of the most annoying things is for people like myself who are in there for alcohol issues... most of your expense for testing is checking for drugs. So I spend a minimum of $200 per month on drug tests when I never even used them and was referred for alcohol...

Right. That totally sucks. Thank goodness I just pay monthly for the test given the month before. It's been anywhere from 3-4 test a month maybe. And at 84$ a pop for the urine screen they do. 

[Quickstepper, MSN, RN]

I don't know if something on the federal level is  the right approach... it seems to me that first, nurses from across the states need to unite on this first. At that point some type of legal consultant would be needed to try and figure out what federal laws are being broken. 

[heron, ASN, RN]

Quickstepper said:

I don't know if something on the federal level is  the right approach... it seems to me that first, nurses from across the states need to unite on this first. At that point some type of legal consultant would be needed to try and figure out what federal laws are being broken. 

Aren't these mostly state-mandated services? Seems like the place to start is at the state level. Privatization can hide a multitude of sins.

[perplexedpa]

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.

Thank you for stating this.  I completely agree and am still learning about this "scheme" b/c as I am educating myself more and finally joined this community.  It seems the "cash cow" definition that has been expressed and the fact that we are not privy to our test results is completely baffling to me as we are constantly throwing money at the program.  We have a new oversight committee this year and it seems more in line for physicians and not nurses; a one size fits all attitude with the same conclusion. 

I just dropped 7K out of pocket; nearing the end of my "time" and I bet after this upcoming (I report for 5 days tomorrow ) inpatient eval that is so-called "recommended" will add more time to my sentence.  I had a alcohol relapse back in March.  It was short.  It was on my time.  I had no idea what a PETH test was otherwise I would have thought twice; my bad but it is over.  

So because this is a one size fits all program including all of those random screens for drugs of which I never used and instead of being called up for tests specific to ETOH, much money has left my bank account and into theirs.

This last chunk of change out of pocket and the time needed to take off from work (hoping I still have a job after all of this) is very disheartening and seems PUNITIVE and NOT SUPPORTIVE.

I will embrace it for what it is and hope that my experience, strength and hope will help another while I am inpatient this coming week for 5 days and see where the chips fall and what will be dictated for my life as per their findings/outcome. 

I have to chuckle b/c I'm sober!

 

[Healer555]

perplexedpa said:

Thank you for stating this.  I completely agree and am still learning about this "scheme" b/c as I am educating myself more and finally joined this community.  It seems the "cash cow" definition that has been expressed and the fact that we are not privy to our test results is completely baffling to me as we are constantly throwing money at the program.  We have a new oversight committee this year and it seems more in line for physicians and not nurses; a one size fits all attitude with the same conclusion. 

I just dropped 7K out of pocket; nearing the end of my "time" and I bet after this upcoming (I report for 5 days tomorrow ) inpatient eval that is so-called "recommended" will add more time to my sentence.  I had a alcohol relapse back in March.  It was short.  It was on my time.  I had no idea what a PETH test was otherwise I would have thought twice; my bad but it is over.  

So because this is a one size fits all program including all of those random screens for drugs of which I never used and instead of being called up for tests specific to ETOH, much money has left my bank account and into theirs.

This last chunk of change out of pocket and the time needed to take off from work (hoping I still have a job after all of this) is very disheartening and seems PUNITIVE and NOT SUPPORTIVE.

I will embrace it for what it is and hope that my experience, strength and hope will help another while I am inpatient this coming week for 5 days and see where the chips fall and what will be dictated for my life as per their findings/outcome. 

I have to chuckle b/c I'm sober!

 

You were almost done and tested positive for alcohol? I'm guessing they will just add time unless maybe it was because you accidentally used mouthwash or something with alcohol unintentionally. Good luck 

[PsychRNXXX, BSN]

perplexedpa said:

Thank you for stating this.  I completely agree and am still learning about this "scheme" b/c as I am educating myself more and finally joined this community.  It seems the "cash cow" definition that has been expressed and the fact that we are not privy to our test results is completely baffling to me as we are constantly throwing money at the program.  We have a new oversight committee this year and it seems more in line for physicians and not nurses; a one size fits all attitude with the same conclusion. 

I just dropped 7K out of pocket; nearing the end of my "time" and I bet after this upcoming (I report for 5 days tomorrow ) inpatient eval that is so-called "recommended" will add more time to my sentence.  I had a alcohol relapse back in March.  It was short.  It was on my time.  I had no idea what a PETH test was otherwise I would have thought twice; my bad but it is over.  

So because this is a one size fits all program including all of those random screens for drugs of which I never used and instead of being called up for tests specific to ETOH, much money has left my bank account and into theirs.

This last chunk of change out of pocket and the time needed to take off from work (hoping I still have a job after all of this) is very disheartening and seems PUNITIVE and NOT SUPPORTIVE.

I will embrace it for what it is and hope that my experience, strength and hope will help another while I am inpatient this coming week for 5 days and see where the chips fall and what will be dictated for my life as per their findings/outcome. 

I have to chuckle b/c I'm sober!

 

Do you see your results at all? I can see if it says negative, prescription positive, abnormal etc. but not specific drugs. 

PsychRNXXX said:

Right. That totally sucks. Thank goodness I just pay monthly for the test given the month before. It's been anywhere from 3-4 test a month maybe. And at 84$ a pop for the urine screen they do. 

Same that's what I pay for. 

[perplexedpa]

We are "told" by the Program if positive but not for what or the degree (ie. PETH > 20ng/mL)

[perplexedpa]

Also, the Program uses the Right to Know Section something, something saying that they are immune from disclosing to those of us who pay any information which I find interesting since it is our information and our pocketbooks.

[Nursekat22, CNA, LPN, EMT-I, EMT-P]

in Minnesota on 3 year contract. UA/meetings/treatment (done) outpatient (done) counseling weekly etc. in a dbt group 3 hours a week on wed night- for a year approx.... my insurance has been covering everything except ua's which I pay 30 a pop at the collection site, and 30 or so at the lab to process.... so 60ish a time.....  My insurance paid for treatment (husband work for ups so great insurance).... but why is this so expensive everywhere else....you have to pay the BON?? you have to pay to be monitored?? what am I missing and am I going to be sent a surprise bill from MN BON or HPSP???

 

[heron, ASN, RN]

Nursekat22 said:

in Minnesota on 3 year contract. UA/meetings/treatment (done) outpatient (done) counseling weekly etc. in a dbt group 3 hours a week on wed night- for a year approx.... my insurance has been covering everything except ua's which I pay 30 a pop at the collection site, and 30 or so at the lab to process.... so 60ish a time.....  My insurance paid for treatment (husband work for ups so great insurance).... but why is this so expensive everywhere else....you have to pay the BON? you have to pay to be monitored? what am I missing and am I going to be sent a surprise bill from MN BON or HPSP??

 

All the benefits of privatization ...

[Healer555]

heron said:

All the benefits of privatization ...

 

Nursekat22 said:

in Minnesota on 3 year contract. UA/meetings/treatment (done) outpatient (done) counseling weekly etc. in a dbt group 3 hours a week on wed night- for a year approx.... my insurance has been covering everything except ua's which I pay 30 a pop at the collection site, and 30 or so at the lab to process.... so 60ish a time.....  My insurance paid for treatment (husband work for ups so great insurance).... but why is this so expensive everywhere else....you have to pay the BON? you have to pay to be monitored? what am I missing and am I going to be sent a surprise bill from MN BON or HPSP??

 

DBT?  For borderline personality disorder? Is that your diagnosis? A three hour therapy appointment? Crazy.