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Meeting of the Board of Regents | July 2007

Wednesday, July 11, 2007 - 11:00pm

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Frank Muñoz



Presentation on the Professional Assistance Program


July 11, 2007









Issue for Discussion


              This report is to inform the Regents of the continued and growing success of the Professional Assistance Program.  The Professional Assistance Program works to protect the public while preserving the ability of valuable licensed professionals to continue in their profession by assisting them to receive treatment for alcohol or substance abuse.  It does this by providing an opportunity for licensed professionals to immediately and confidentially surrender their licenses while in treatment and by strict monitoring of professional practice for at least two years after licensees return to practice.  In a cooperative project with the New York State Nurses Association, many more professionals are receiving peer support and comprehensive services.


Reason(s) for Consideration


To present requested information to the Regents about the Program’s role in protecting the public.


Proposed Handling


This issue will come before the Higher Education and Professional Practice Committee for discussion at the July meeting.  A brief presentation of program history, processes, progress to date and future opportunities will be followed by discussion. 


Procedural History


              Article 130, Section 6510 of Education Law established the Professional Assistance Program and the Committee for Professional Assistance to advise the Board of Regents on matters relating to practice by professional licensees with drug or alcohol abuse problems.   This report is an update on how the Program and the Committee are fulfilling the Regents recommendations from previous updates in March 2000 and January 2002.


Background Information


Since 1985 the Professional Assistance Program (PAP) has been a vital component of the professional discipline process.  The PAP has successfully addressed the substance abuse problem for almost 2,000 licensees who participated in the program.  Services are not limited to Program admission.  Outreach and referrals are key responsibilities.  Outreach by the PAP included distribution of several hundred thousand program brochures and numerous other services to the public.  Professional licensees, employers, community groups, associations and agencies received advice, referrals, training, or information.


              The PAP was designed as a voluntary, confidential program in order to encourage professionals with substance abuse problems to come forward for treatment in spite of fears of public exposure of their problem and potential jeopardy to their careers and professional licenses.  The mission of the PAP is accomplished through the immediate surrender of the professional license, referral to appropriate treatment and strict monitoring of future professional practice for a minimum of two years.  The Program is available to all licensed professionals except physicians, physician assistants, and specialist assistants.  A separate program regulated by the Department of Health is available for those professionals. 


Drug abuse remains a major issue in the professions.  Estimates of its prevalence vary.  The Journal of the American Medical Association (JAMA 2005) reports a figure on drug abuse of up to 15% for physicians at some point during their careers.  Drug use, short of addiction, is estimated at 20% for health professionals such as nurses, pharmacists, and dentists.  Drug misuse or abuse in the non-health professions is estimated at the national average of 10-12%.  This is a potential threat to the public as well as to professionals.  Without programs such as the PAP, many professionals might practice while impaired out of fear of loss of their license or fear of public exposure of their substance abuse problem. 


Applicants to the PAP are often referred to the Program by employers or professional associations.  Many applicants are referred by the Office of Professional Discipline.  However, professionals may not be admitted to the PAP if they have inflicted patient or client harm.   Participation in the Program may protect the licensee from some charges of professional misconduct and may be viewed favorably when penalties are considered in administrative or other proceedings.





Committee for Professional Assistance


              The Program is guided by a committee appointed by the New York State Board of Regents.  The Committee for Professional Assistance has the statutory obligation to advise the Board of Regents on matters relating to practice by professional licensees with drug or alcohol abuse problems and to assist in the administration of the PAP.  Over forty volunteer Committee members assist the Program by working with staff on program policies and procedures; keeping the Department informed of major issues and innovations in the field; and serving as hearing panel members to determine admission into the Program, treatment level requirements, restrictions on professional practice, and Program compliance.


Program Processes


The applying professional must appear at a hearing comprised of three members of the Committee for Professional Assistance and a member of the state board of the profession of the person appearing before the panel.  Once a professional is accepted into the Program, he or she surrenders their license and cannot practice.  The professional is assigned to a PAP caseworker who maintains regular contact; monitors treatment progress, reviews work site monitor reports and drug screen reports; and provides referrals to services. 


              When a professional has completed treatment and feels ready to return to practice, that professional appears before a hearing panel which decides whether to reinstate the license.  If approved, the professional must have a work site monitor and provide regular reports and accept random drug testing.  Routine forty-five minute “status” meetings with hearing panels are also scheduled at least quarterly to maintain oversight of the case.


As the Program continues to grow, the PAP has employed a number of innovative approaches to handle the surge in admissions.  These include a highly successful document imaging project which eliminated the need for paper files on participants while also dramatically increasing the privacy and security of the files, as well as increasing the speed of response to inquiries from participants and others.  The Program, with the assistance of the volunteer Committee members, has increased the number of hearing panel meetings with participants to nearly 80 per month.


Cooperative Effort of the Program and the New York State Nurses Association


              With the passage of Chapter 290 of the Laws of 2000 and a $1.4 million annual contract between the Department and the New York State Nurses Association, services available to nurses with drug-related problems are now more comprehensive than ever before.  The 2000 law increased access to PAP services for nurses and created a funding stream by adding a $15 fee to nurse registration.  PAP and the New York State Nurses Association now work together on most nurse cases.


              This cooperative project between the Office of the Professions and the New York State Nurses Association has led to the provision of an integrated, highly structured support system for nurses with drug-related problems.  Under this contract (administered by the Office of the Professions) the PAP and the New York State Nurses Association’s Statewide Peer Assistance Program for Nurses (SPAN) provide complimentary, but equally vital, services to the same population.  With SPAN providing nurse peer support and advocacy and PAP providing practice monitoring and treatment coordination, participating nurses receive the best possible structured support.


Statewide Peer Assistance for Nurses


              The SPAN program was designed to be a resource for nurses.  It performs outreach and support services to nurses who have problems with the misuse of drugs or alcohol and related mental health problems.  SPAN promotes working environments that support the delivery of effective, efficient and safe patient care, while preserving a patient’s most valuable resource –- healthy, capable nurses.  It does this by offering a range of services to nurses and the healthcare community throughout New York State.  To date, more than 1,100 nurses have participated in SPAN.  SPAN offers direct services to individuals in all 12 Judicial Districts.


SPAN provides a number of very important services such as direct education and literature distribution aimed at prevention, early identification and intervention of drug-related problems in nurses.  SPAN informs, supports, and advocates for nurses.  SPAN also offers needs assessments, referrals to professional resources, and troubleshooting for immediate concerns.  Other services include:


  • maintaining a toll free 24-hour-a-day, 7-day-a-week, telephone information line for nurses, their employers, and others to receive assistance in identifying services and information regarding nurses with drug-related problems (1-800-457-7261);
  • providing each nurse in SPAN with a volunteer advocate for one-on-one support;
  • providing trained regional coordinators to support volunteer advocates, provide direct support to nurses in the program, and engage in outreach activities;
  • engaging in ongoing statewide outreach efforts to nurses, their employers, and the public;
  • training of PAP worksite monitors;
  • providing the PAP with progress reports on individuals who are enrolled both in SPAN and the PAP;
  • Offering peer support group meetings to program participants.  These are focused sessions at which nurses at all stages of  recovery share concerns regarding licensure, practice and recovery issues, and process healthy behavioral strategies. 


At the March 2000 meeting of the Higher Education and Professional Practice Committee, the Regents recommended that the PAP consider working with professional associations and expanding outreach to achieve PAP goals.  The Program has followed this advice and the result is improved effectiveness in responding to drug abuse especially in the nursing profession.  SPAN works closely with the PAP in providing these services.  Many SPAN participants are also enrolled in the PAP.  PAP and SPAN continue to expand outreach efforts so that every licensed professional is aware of the program.  Even though over 120,000 informational brochures are mailed out every year with registration packets, more needs to be done.  Efforts are underway to provide electronic links to the PAP web page and plans are being made to expand public relations to include public service advertisements.


Over the past seven years the effectiveness of our response to the problem of alcohol and substance abuse in the licensed professions, particularly in nursing, has been dramatically enhanced.  We are reaching more professionals in need and we are reaching them earlier.  The provision of this thorough, structured support system to aid in their recovery is making a major difference.  By doing this we not only affect the life of the professional, but we also protect the public from impaired practice, improve the quality of professional practice, and aid in addressing professional shortages in New York State by returning highly trained, experienced professionals back to safe professional practice.





              Staff recommend that the Regents continue to actively support the Professional Assistance Program and provide guidance in light of the updated information.



Timetable for Implementation