XPost: alt.recovery.addiction.alcoholism, misc.emerg-services, a   
   t.fan.rush-limbaugh   
   XPost: talk.politics.guns, sac.politics   
   From: democrat-insurrection@mail.house.gov   
      
   https://calmatters.org/health/2024/12/board-of-registered-nursing-   
   addiction-recovery/   
      
   Bobbie Sage thought nursing would be her salvation. She was trapped in an   
   abusive relationship with four kids and looking for a steady income. The   
   day she graduated vocational nursing school, she took the kids and left   
   their father.   
      
   Five years later, a DUI ruined her carefully crafted stability. Sage was   
   waiting for a taxi outside a bar with another partner when he began   
   hitting her, she said. She fled in her own car. A mistake with enduring   
   consequences.   
      
   Sage was charged with a misdemeanor for driving under the influence of   
   alcohol in 2014. She paid a fine and completed three years of criminal   
   probation without incident, according to court documents. She thought that   
   tumultuous period of her life was over until her state licensing board   
   ordered her to complete an additional probation program for health   
   professionals with substance use problems.   
      
   Sage couldn’t afford the drug tests at $300 a month or a fine of $3,140.   
   She dropped out. She surrendered her vocational nursing license in 2019   
   and blames the program for ending her career.   
      
   Now, Sage is among dozens of health care workers who allege they’ve been   
   mistreated under a California law governing workers with addiction and   
   mental health problems. They say state regulations are needlessly   
   punitive, overly bureaucratic and based on faulty addiction science. They   
   call it a trap that prevents them from working and leaves many of them   
   with thousands of dollars of debt.   
      
   “One misdemeanor is costing my entire life,” Sage said. “Punish me for   
   something with my (nursing) license that I’ve done with my license.”   
      
   The 2008 law was supposed to protect patients after a series of audits and   
   legislative hearings suggested licensing boards were doing a poor job of   
   keeping impaired health workers off the job. It created uniform   
   regulations for each board to follow that stipulate exactly how to deal   
   with these workers, including extensive drug testing, travel restrictions   
   and psychiatric evaluations meant to catch anyone who relapsed.   
      
   Some boards created recovery programs as an alternative to discipline.   
   Workers could volunteer to join as a step toward their recovery, or be   
   asked to join by their licensing board as a substitute for public   
   punishment. Others, including Sage, were ordered into a parallel probation   
   program after an incident such as a DUI or other licensing violation.   
      
   Nurses say those provisions have become so burdensome and expensive that   
   health care workers avoid the recovery program outright unless a licensing   
   board asks them to join. As a result, the state is monitoring fewer   
   workers than ever. Fewer than 400 people are enrolled, down from a peak of   
   more than 900 in 2010.   
      
   The recovery program has never included doctors, whose lobby resisted it   
   because members believed it was too punitive, according to Gail Jara,   
   executive director of California Public Protection and Physician Health,   
   an organization dedicated to creating a new recovery program for doctors.   
   The California Medical Board, which licenses most doctors, plans to push   
   for an alternative program in the Legislature in the coming year.   
      
   “It’s living hell,” said an emergency room nurse interviewed by CalMatters   
   who joined voluntarily. The nurse asked for confidentiality because she   
   could lose her license for speaking out under the terms of her contract.   
      
   The nurse has been unable to find a job that meets the program’s strict   
   work limitations for nearly two years despite clean tests. She has spent   
   more than $8,000 on drug tests, according to receipts, several thousand   
   more on medical and psychological evaluations, and more than $20,000   
   paying for health insurance because she lost her work insurance.   
      
   Dentists, physical therapists, veterinarians and other health workers   
   whose professional licensing boards are overseen by the California   
   Department of Consumer Affairs are subject to the state law. Nurses make   
   up the majority of the participants, and complaints about the program have   
   erupted at recent Board of Registered Nurses meetings.   
      
   Many say they’ve followed all the rules and still see no way out even   
   after years of demonstrated sobriety.   
      
   Officials at those meetings faulted minor changes they made to increase   
   oversight, suggesting they went too far. Participants and addiction   
   experts interviewed by CalMatters, however, say the law itself is the root   
   of the issue.   
      
   “We’ve built systems that are completely onerous and agnostic of the value   
   of a human life,” said Amanda Choflet, dean of nursing at Northeastern   
   University in Boston and an expert in nursing addiction programs. “It’s   
   not even that the systems themselves are actively trying to keep people   
   from being able to recover. It’s that the systems aren’t built for humans.   
   They’re built in order to enact legislation.”   
      
   A group of consumer advocates that pushed for the law argues that it is   
   doing exactly what it is meant to do — impose consequences on workers who   
   can’t stay sober. Michele Monserratt-Ramos, a patient advocate with   
   Consumer Watchdog, said licensing boards’ first duty is to protect the   
   public, not shield health workers with substance use or mental health   
   disorders.   
      
   Many of the requirements that nurses and other workers say are intolerable   
   such as work prohibitions were designed to protect patients, said   
   Monserratt-Ramos, whose fiance died after an operation with a doctor who   
   had a history of substance abuse. If health workers know addictive   
   behaviors and other impairments will be scrutinized by their licensing   
   boards, they’ll be less likely to do something harmful, she said.   
      
   “The safety net now is the consequences,” Monserratt-Ramos said.   
      
   The Department of Consumer Affairs did not make anyone available for an   
   interview, stating that the regulations governing the program were written   
   by a committee years ago and no experts were available. In a statement,   
   the department said each health care board is independently responsible   
   for implementing the program, and eight boards contract with an outside   
   vendor, Maximus Inc., to do so.   
      
   The Board of Registered Nursing refused several times to make executive   
   staff or board members available for an interview to address participants’   
   complaints. Individual board members also failed to return calls or emails   
   from CalMatters. In a statement to CalMatters, board staff said they have   
   already addressed such complaints and are working to address more.   
      
   Maximus, a publicly traded company worth $4.5 billion, did not respond to   
   several interview requests. The vendor’s $12.4 million state contract   
      
   [continued in next message]   
      
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