KyBeagle

You’re correct, it does. They did tell me in my first meeting, when I signed the agreement, to notify them when going out of town. Based on my experience with KARE, if I had been out of town & provided a sample, nothing would have come of it. We definitely weren’t prisoners. They understand that things come up daily & a 2 week notification wouldn’t be feasible. Honestly, I think the inclusion is more of a protection for the program. If something came up, couldn’t find a place to test, didn’t get the test, etc., then liability would be on the Participant, not the Program, base on the signed Agreement. However, I DID always notify them, simply based on the trends observed within my HP group. Not selected to test DURING vacations but always a day or 2 upon return, LOL! If there was the slightest chance they were pausing testing during the dates I provided them, I was taking advantage of that. Of course, I still worried about being selected & make alternative plans in case I was. But, thankfully, it never happened.

@solarex This is a great point. I always did this, as well, and I’m glad you thought to mention it. In fact, when my primary collection site built a new facility & moved, I was aware because I was in there regularly. However, I didn’t notice that their address listed on the Affinity site wasn’t updated -UNTIL 6 MONTHS LATER! When I finally caught it, I immediately contacted Affinity to let them know. It took another 2 months for it to be updated. (When I contacted them a 2nd time, they said they were waiting on official verification from the office). So- yeah. Always call & double-check accuracy. You don’t want to find yourself in a pinch if the info is outdated.

In KARE (KY), the agreement stipulates that you must notify your Case Manager 2 weeks prior to travel. It isn’t worded as “permission” & my Case Manager never treated it as such. Per the KARE handbook: “Your Case Manager must be informed of any travel affecting your drug testing obligations (I.e., vacations, etc.) in writing at least two (2) weeks prior to the start of absence from home. You must contact Affinity (via webiste or phone) to obtain information regarding collection sites should you be selected to test while away from home. Regardless of the reason for being away from home, you are still held accountable for meeting all requirements of the random drug screening program, including contacting Affinity on a daily basis”. In KY, you don’t get “vacation days”. You’re expected to check in daily, including weekends & holidays. Case Managers do not “excuse” you from testing during out-of-town trips. However, I was aware of only 1 instance that someone was actually selected to test while on vacation, and this person vacationed frequently. The majority of nurses in my Health Professionals group (including myself) were always “randomly selected” to test within a day or 2 of returning from vacation! So we always notified our Case Manager before travel, speculating that perhaps CMs sometimes DID arrange vacation-free testing, if a participant was compliant, but did not want us to be aware (to avoid vacation relapses). Regardless,when making travel plans, after booking a hotel, I would always check the Affinity app & find the testing sites closest to my hotel. I usually scoped everything out a few days or week before traveling, making sure I found sites that best suited my travel plans, in case I was selected. If traveling outside the US, going on a cruise, etc., KARE CMs look at these on a case-by-case basis. If you’re compliant in the program, you don’t have to wait 5 years for your dream vacation. I’ve known several nurses that had trips abroad approved & were just subject to additional testing upon return. So, definitely a few extra hoops to jump through, but vacationing is certainly possible. I took a couple each year. When planning your itinerary, just remember to include a some flexibility in the mornings, in case you’re selected to test.

My program (KARE) used Affinity for testing. Payment for the UDS was through them. People do things differently. Some pay their account at the time of testing. I was worried something big could financially hurt me (BESIDES TESTING) & I would not have the $$ someday. So whenever I received my tax refund each year, I always deposited about $600-$800 into my Affinity Account so I wouldn’t stress about finances. When balance would start dropping as the year progressed, I’d start adding $100-$150 here & there. The clinic I used for testing wasn’t through Labcorp so I had to pay the $15 - $20 collection fee at the time I was tested.

I “graduated” a couple years ago from KY’s KARE program. I had saved a copy of my Affinity result log & pulled it up to answer your question. (By “result log”, I just mean the dates of the tests & the vague “positive” or “negative” result). As far as testing frequency- it varied. First year, I had a total of 24 tests at exactly 2 per month. Program Year totals: 2 (23 tests); 3 (18 tests); 4 (19 tests); and 5 (20 tests). In years 2-5, I usually tested 2x/month but sometimes once per month. The final 6 months of the program I had a couple of months with testing 3x/month. The frequency was random- I had 40 days between tests- and also had 5 days between tests. I only had one blood test. The rest were urine. No hair tests. The price for the majority of UDS’s was $41.50 (plus a collection site fee of $15-$20, depending on where I went ). I would also have about 4/year @ $65. (I’m guessing the $65.00 also tested etg). It was very obvious that the frequency increased the final 6 months of my 5th year. I had just gone about 4 months in a row with 20-35 days between tests & my bank account was SO appreciating the rest ? - then… BAM! I had a spell of something like 6 tests in 7 weeks, with only 5-7 days between a few of them! When I asked my CM, she said it was very common for Affinity to increase the frequency towards the end of the program to ensure compliance. My checking account did not like being woken up from it’s nap! ? ??

While at home sick today, I came across your post again from a year ago. And literally almost DIED. ☠️The laughter caused a coughing fit so intense that I couldn’t get under control until I took a Duoneb treatment. (Okay, maybe I didn’t almost actually die, but it sure felt like the Duoneb was lifesaving)! I can’t believe that I had forgotten about your post. Just curious if the Infection Preventionist is still in her position at “CBG”? I think I remember you saying in another post that the Health Dept was already well aware of her crazy beliefs, because they had heard from other people. And I’d LOVE to know… with the additional protective measures that weren’t available a year ago… is it now safe for VACCINATED nurses to talk on the phone????️☎️ ?

I’m not a CRNA but I’m an RN. I was in the program 2014-2019 & VERY compliant. I think was striving to become their poster child. I asked a couple of times if the 5 year “sentence” could be reduced- that answer is a hard “NO”! As I progressed through the 5 years, I had my contract updated to reflect that I was allowed to administer controlled meds w/o visual supervision & work in a supervisory/managerial role. But these happened at the timeframes that’s usually stipulated in the KARE contract, after showing continuous compliance. They weren’t things I negotiated independently.

I’m simply curious to know how this story ends! I feel like I’ve been watching a movie on TV & the cable went out right before the end! Did HR get back with you? Did you work Saturday?

That’s fantastic! I wish more programs provided leads for potential employment opportunities.

When I entered my state’s 5 year diversion program several years ago, I applied & was hired into a Case Management/your position. Initially, after thanking my lucky stars for getting a job, I had planned for it to be short-term until my narcotic stipulation was removed in 12 months. However, I loved the job & found it intellectually challenging without the fatigue of 12-13hrs running circles in the ED. 7 years later, I’m still in the same role just expanded to a lead/charge type position. I would’ve never switched from ED to this type of nursing position had I not been forced to leave ED. Although I wish I had made better choices 7 years ago, I’m grateful that the situation lead me to this job. I love it!

Congratulations! Now you can breath again!

791750 is a urine drug test specific for Kratom (Mitragynine). The code is actually listed on Labcorp’s website which is unusual. For most panels, Affinity had created CPT codes that are different than what is listed on Labcorp or Quest’s websites (to keep participants from knowing what’s being tested). I don’t think Kratom is something they routinely check unless they either have a suspicion of it being used or if it was your DOC before entering IPN. For example: When I was in my state’s ATD program, I knew that Ambien wasn’t something that they routinely checked - but they could. There was a nurse in my Healthcare Professionals group that “randomly” got picked for a special “O” panel test every month that rest of us never got. However, since one of her DOC was Ambien, we suspected that’s what that panel was. When I was almost out of the program (2019), someone mentioned how trends had changed, giving an example that buprenorprine used to only be included on a few select panels, but was now being added to the majority of the routine panels. For 5 years, I simply assumed that every banned medication was on every panel. From Dilaudid (my DOC) to Benadryl. I was afraid that if I EVER rationalized taking a Benadryl or any other banned OTC med without a doctor’s note, it would guarantee that I’d be tested for that particular med the next day, LOL!

@Stainahb @RNforthecause I'm thankful to see 2 nurses who didn't NEED a disciplinary or ATD program escape this punishment. Too many times I've come across stories like both yours on this forum, and seen nurses trapped into 3-5 year contracts that they didn't deserve. Mainly, though, I just want to thank you both for giving updates. I used to be on this forum quite often, back when I was in my state's 5 year ATD program (which I DID deserve). It can be SO frustrating to come across posts where the OP asked a question but never returned to give an update. In this circumstance, not just ONE but BOTH of you returned a year later with updates on your individual situations. That's wonderful! Just letting you know that's very much appreciated! I'm sorry that you got a public reprimand @RNforthecause but I'm glad you're both otherwise unscathed. Best Wishes!

In 2019, I completed the 5 year KARE program (KY). They utilize LabCorp (Affinity). I never had a Hair test & only one blood test in 5 years. Otherwise, it was urines 1-2 times/month (3X/month once). Urine tests were usually $41.50. Three - four times per year I would have a $65.00 urine test (I’m guessing these included etg). Tests were paid directly via the Affinity app. Collection site fees were $10 at Labcorp sites. However, the closest Labcorp was about 45 miles away from me. Thus, my specimen collections were always done at a nearby occupational therapy (OT) office. Collection site fee were paid directly to them each visit. Fees were $20.00 for a “Dry room” collection or $45 if observed (had 2 observed in 5 years). The one blood test (PEth) that I had was $120 or $130 for the test (can’t recall exactly) & $20 for the collection site fee. Since I never had a hair test, I don’t know what KY’s actual hair tests cost but heard they were expensive. The collection site fee for hair at the OT clinic that I utilized would have been $40. In 5 years with KY’s program through Affinity, I had a total of 104 urines, 1 blood test, & no hair tests. I had to check in 7 days/week. I couldn’t see a pattern to the “randomness”. Sometimes I was picked after a holiday & sometimes not. I was never picked on a holiday or weekend (although, in the past year or so, I’ve read on this site that one nurse in the KARE program was picked on several Saturdays in the last 2 months that she was in the program). I was never picked out-of-state when on vacation although I knew a nurse that was. I guess that I could see a difference in the frequency. In both the first AND last 12 months of the program, I had 2 tests/month (with 3 times in one month about 3-4 months before finishing). The middle 3 years I would have 4-5 months each year with only 1 test (2X the other months). With the exception of no weekend selections, I still never saw any type of a pattern with the randomness.

I think these are excellent tips. Although, I have never actually seen these all written down together, I pretty much followed all of these in my 5 years in KARE & successfully completed my program. I agree with 8 all tips (well, mostly). My only disagreement is the statement regarding the first year. OK, I know that there are historically “peak times” for relapse & 1 or 2 fall within the first year. However, I will say that my first year was the best. I was new to the program, sober, and did NOT want to lose my license. Being reported to the BON was MY “rock bottom”. That first year, I was equivalent to an “A+ Student”, dotting every I & crossing every t. There was NO WAY that I wanted to be discharged. Unencumbered license was my goal & within sight (well... 5 years away, but still doable). I did continue to follow these tips in the years 2-4. However, I wasn’t as tense or paranoid. Daily Affinity check-ins & random UDS became the norm in my life- routine. I knew what I could & could not eat. With weekly meetings I improved my coping skills, rarely having cravings but handling them in a healthy way if I did. Okay- I definitely agree with you on the last year. I STILL followed these tips & continued my sobriety. The first 6 months of the 5th year was status quo. The the last 6 months- OMG! Yes, I felt restless! I was irritated by the daily check-ins and the monthly paperwork that I had to send in. I was just TIRED of it! I had NEVER resented the KARE program until the final 6 months. Prior to that I had always felt grateful for it- allowing me to keep my license & remaining confidential. But, WHEW! The day I completed, I felt a 100lbs were lifted from my shoulders. I have continued my sobriety (graduated 1 year ago). No, I was never compelled to use opioids during that 5th year. I just was chafing to return to a “normal life” that didn’t involve panicking every time we were on vacation or out of town, praying that I wouldn’t get chosen for a UDS (inconvenience). Basically, I did what @StarlaBanks says to do- I put my head down & powered through. And FINISHED! Anyway- I’ve completed the program & happier today than I was most days before the KARE program. Those 5 years gave me time to figure out other, healthier coping mechanisms for my life, other than just retreating to oblivion with narcotics. I’m much happier now.