Diversion Program FAQ & Forms
What is the Diversion Program?
- The Diversion Program is a confidential, voluntary alternative to formal disciplinary action for nurses who may be chemically dependent because of habitual or regular use of drugs and/or alcohol.
Why was the DP established?
- It is estimated that 14% of all licensed nurses are dependent on alcohol and/or other mind-altering drugs. Historically, a disciplinary approach to problems with addiction was the normal course of action in the nursing profession, as well as in other health care professions. In the early 1980's, the nursing profession began to proactively address the problem of addiction in its ranks. They began to examine the issues of chemical dependency and addiction in nurses from a rehabilitative, rather than a disciplinary, approach. The first two alternative diversion programs were established in California and Florida. New Mexico became the third in the country to establish a diversion program.
- In 1987, the New Mexico state legislature enacted Section 61-3-29.1 of the Nursing Practice Act that authorized the Board of Nursing to establish a diversion program for chemically dependent nurses. A nurse who habitually or regularly uses alcohol and/or other mind-altering drugs presents a potential danger to her/her patients because the use of chemicals can impair the nurse's ability to safely practice nursing. When identified, the nurse can be referred to the Diversion Program and begin a program of rehabilitation to address the chemical dependency problem.
- The purpose of the Diversion Program is to monitor nurses in the first months and years of their recovery, and track compliance with their sobriety and recovery work. It is not the intent of the program to provide treatment or therapy to chemically dependent nurses. However, the initial contract signed by all nurses requires them to receive some form of treatment for chemical dependency. The program initially provides a strict external structure of recovery for nurses whose lives have become unmanageable due to their abuse or addiction. The goal of the Diversion Program is to enable these nurses to integrate this structure internally and be able to manage their lives effectively again. When this has been accomplished, the nurses are ready for discharge.
What are the objectives of the Diversion Program?
The primary objectives of the Diversion Program are:
- To protect the health and safety of NM citizens.
- To identify chemically dependent nurses or nurses at risk for a chemical dependency before the disease progresses to the point where valuable nurses are unable to practice nursing because of the use of drugs or alcohol.
- To assist the nurse to get the appropriate help he/she needs to stop using drugs and alcohol and to receive treatment.
- To keep the recovering nurses productive by helping him/her to remain in practice or return to practice as soon as possible.
- To monitor the nurse's practice and recovery for whatever period of time is necessary to assure that the nurse is a safe practitioner.
- To report non-compliance and/or violations of the DP contract to the Board of Nursing.
- To educate the public and nursing profession about chemical dependency and impaired practice.
How can a nurse be referred to the Diversion Program?
- Nurses are admitted into the Diversion Program through one of three methods. Because the program is only for chemically dependent nurses and is voluntary, the nurse must specifically request admission in writing, and indicate that they are chemically dependent. This letter is sent to the DP Coordinator or Executive Director of the Board.
- A nurse may request admission subsequent to the receipt of a complaint received in the Board of Nursing office.
- A nurse may report his/her own problem with drugs/alcohol and request admission in the program.
- A nurse may request admission into the program in lieu of formal Board action against their license or as a condition of reinstatement of their license following a suspension or revocation.
Who is eligible to participate in the Program?
- Any R.N. or L.P.N licensed in the state of New Mexico who habitually uses or is addicted to alcohol and/or other mind-altering drugs and who requests admission into the Program.
What are the requirements for participation in the Program?
- Nurses who request admission will be sent a new participant packet to review prior to their admission. This packet includes all the pertinent information about the requirements for participation, including a copy of the initial contract that will be signed by all participants. They will be scheduled to meet with the Diversion Program Coordinator for an admission interview.
- The initial contract signed by all participants is a five-year contract, in which the nurse agrees to be monitored by the Diversion Program during that five-year time frame. The requirements of the contract include:
- Admission of a problem with chemical dependency.
- Treatment for chemical dependency. A minimum of intensive out patient treatment is required.
- After initial treatment, participation in an aftercare group for a period of one year.
- Complete abstinence from all mind altering drugs, including alcohol.
- Regular, random drug and alcohol screens according to the protocol for the Diversion Program.
- Regular, verified attendance at support group meetings such as Alcoholics Anonymous and monthly submission of attendance sheets.
- Submission of monthly, written self-assessment letters addressing recovery issues.
- Submission of regular reports from work place supervisor regarding work performance.
- Submission of regular reports from the treatment and aftercare counselors regarding participation and cooperation with treatment.
- Mandatory, regularly scheduled face-to-face evaluations with representatives of the Diversion Program and submission of signed contract amendments.
- Practice stipulations regarding return to work issues usually include:
- no access to narcotics or keys for a minimum of one year.
- no agency, traveling nurse or home health work for a minimum of one year.
- no night shift work for a minimum of one year.
- no overtime for a minimum of one year.
How do I as an employer know if a nurse applicant is in the Diversion Program?
- Nurses in the Diversion Program are required to inform their employers and prospective employers that they are participants in the DP. Upon request from the employer, they should be able to provide a copy of their initial contract with the DP, as well as any subsequent contract amendments. These documents will provide information about current practice stipulations and contract requirements. Contract amendments are completed with each nurse in the DP at their mandatory face-to-face evaluations, which are conducted a minimum of every three months while the nurse is in the DP. These contract amendments provide a status report on the nurses' participation and ongoing compliance with the DP.
Can I as an employer call the Diversion Program for information on a nurse?
- Participation in the DP is confidential. The DP Coordinator cannot discuss any information about any nurse who is in the DP with anyone else. However, signatures on the initial contract or contract amendments constitute a release of information for the nurse involved. Signatures required on the contract and contract amendments include the nurse participant, the nursing supervisor, the treatment counselor, the AA sponsor, the drug screen coordinator, and a significant other. The primary physician or health care provider also signs the initial contract but not the subsequent contract amendments. So, if you as an employer or supervisor have signed the contract or a subsequent contract amendment, and it has arrived in the DP office, you would be able to call the DP and discuss information about that nurse.
- Any nurse in the DP can also sign a release of information for anyone else that they want to have information about their participation.
- The DP Coordinator will be happy to provide general information about the DP conditions of participation and contract requirements with anyone who wants to call to get that information. This information can often provide adequate answers to most questions without the need to discuss particular participants.
What can I do about a nurse I am concerned may have an abuse or addiction problem?
- If you are concerned about a colleague at work, and you have evidence of violations of the NPA, as a nurse, you are required to file a complaint against the license of the nurse in question. This is the quickest and best way to intervene with a chemically dependent colleague. It is also the way 90% of the nurses enter the Diversion Program. When a complaint alleging issues with drugs or alcohol is received in the Board of Nursing office, that nurse is automatically sent a letter offering him/her admission into the DP. Most nurses who do have issues with drugs or alcohol are relieved to be able to begin to address these issues directly, and they do request admission into the DP. If a nurse does not request admission into the DP, then the complaint would go through the normal disciplinary channels. If a nurse is not chemically dependent, then they would not be eligible for admission into the Diversion Program.
- If there is no clear violation of the NPA, yet there are behavioral or work place concerns, then reporting these concerns to a supervisor is important. Particularly when there is a pattern of concerns, the documentation of all incidents is important to establish. The issues could then be addressed with the nurse. Because of the heavy stigma that continues to be attached to chemical dependency and issues with addiction, people in general and nurses in particular, may find it difficult to admit to these problems. However, if everyone who was concerned about an individual would address his or her concerns with that individual, it would be more and more difficult to continue to deny there is a problem.
How can I get additional information or get in-service training regarding impaired professionals and the Diversion Program?
- You can contact the Diversion Program Coordinator at 505-841-8345 or the Executive Director of the Board of Nursing at 505-841-9082 for additional information or questions.
The Diversion Program Coordinator is available to conduct in-service training for staff or nursing students. Training can be arranged for one to four hours, depending on the topic and needs. Topics can include: "Substance Abuse in Nurses" and "The Impaired Professional and Violations of the Nursing Practice Act." Contact the DP Coordinator at 505-841-8345.