CONTRACT BETWEEN THE KANSAS STATE BOARD OF NURSING
AND the KANSAS NURSE ASSISTANCE PROGRAM, INC.
FOR IMPAIRED LICENSEE MONITORING SERVICES
Section 1. Parties
This contract is made and entered into on this day of ___, 2011, between the KANSAS STATE BOARD OF NURSING (hereinafter, Board), and the Kansas Nurses Assistance Program, Inc. on behalf of its Impaired Provider Committee (hereinafter, Program Provider). The Kansas Nurses Assistance Program, Inc. is a professional organization incorporated not for profit under the laws of this state. The Impaired Provider Committee is a standing committee formed by the Kansas Nurses Assistance Program, Inc. and is an impaired provider committee within the meaning of K.S.A. 65-4924(b).
By signing this document, the representative of the Program Provider represents that the Program Provider has legal authority to enter into this agreement, and that such representative is duly authorized by the Program Provider to execute the same on behalf of the party of the contract. It is agreed that the provisions of this contract are binding on the Kansas Nurses Assistance Program, Inc., the Impaired Provider Committee, their officers, employees, Program volunteers, designees, and subcontractors.
Section 2. Definitions and Construction
(a) The following terms and their derivatives have the following meaning ascribed thereto:
(1) "Impairment" means the inability to practice the licensee's profession with reasonable skill or safety due to physical, mental, or emotional disabilities, disease, including deterioration through the aging process, loss of motor skill, or abuse of alcohol or drugs as defined in KSA 65-1626(k).
(2) "Reportable incident" means an act by a licensee which:
(i) is or may be below the applicable standard of care and has a reasonable probability of causing injury to the patient; or
(ii) may be grounds for disciplinary action by the Board, except that, for the purpose of this agreement only, "reportable incident" does not include habitual intemperance in the use of, or addiction to drugs or alcohol.
(3) "Licensee" means a registered nurse anesthetist, advanced registered nurse practitioner, registered professional nurse, license practical nurse, or licensed mental health technician who is granted a license or certificate of authority by the Board or an applicant during the licensure process, except as otherwise approved by the board. The term shall not be construed to include an individual whose license or certificate has been revoked or has lapsed without reinstatement, either prior to or during the course of enrollment in program services.
(4) "Program," or "program for impaired licensees," means a system for providing monitoring services as stated in Section 3, 4, and 5 of this contract for impaired licensees.
(5) "May" means that a designated act is permissive and not mandatory.
(6) "Shall" means that a designated act is mandatory, and failure to perform such act is a breach of this contract.
(7) "Referral" means a licensee who has been determined by the:
(i) Board to require evaluation, treatment or monitoring as a protection of the public; or
(ii) Program to require evaluation for impairment.
(8) Contract refers to the document reflecting the agreement between the Kansas State Board of Nursing and the Kansas Nurses Assistance Program, Inc.
(9) Agreement refers to the document reflecting the understanding and terms of relationship between the licensee and the Program.
(10) "Intervention" is a process that occurs at different levels of intensity and involves the offer of the Program's assistance to the licensee.
(11) "Monitoring" is the process of assessing and recording behaviors which support recovery and meet requirements set out in Board orders or agreements with the licensee and may include, but is not limited to: random drug screens, communication with treatment providers, documentation of attendance at mutual help groups, meetings and other communication with Program participants.
(12) "Non-compliant" includes but is not limited to when the participant:
(i) does not sign an agreement within 15 days following referral from the Board or within 30 days following an offer by the Program if the licensee is unknown to the Board;
(ii) refuses to submit to evaluation or treatment;
(iii) fails or refuses to cooperate with the Program;
(iv) indicates by his\her behavior that the impairment is not substantially alleviated through treatment; or
(v) violates the terms of the agreement or a Board order or Board agreement.
(13) "Extended evaluation" will be for at least six months and could be up
to a maximum of one year and includes but is not limited to:
(i) signing an evaluation agreement;
(ii) re-evaluation by a therapist chosen by the Program Provider even if the participant has to pay for the evaluation;
(iii) random urine drug screens to average one per month;
(iv) quarterly reports from employer(s) regarding job performance as a nurse or mental health technician;
(v) may be required to attend open twelve-step meetings; and
(vi) may be required to attend counseling and/or an educational program.
(b) The following conditions control construction of this contract:
(1) This contract shall be subject to, governed by, and construed according to the laws of the State of Kansas.
(2) Any actions to enforce or construe any provision of this contract shall be commenced in the District Court for the State of Kansas, Third Judicial District.
(3) This contract is entered into for the sole benefit of the parties of this agreement, and creates no express or implied substantive right in any licensee or any other person.
(4) This contract shall not be construed to require the Board to refer any licensee to the Program Provider and specifically this contract shall not be construed to require the Board to refer any person licensed in Kansas but practicing nursing or mental health technology outside of Kansas to the Program Provider. Pursuant to any order of a hearing officer or panel, or of the agency head, as defined by K.S.A. 77-502, made in the course of an administrative procedure, the Board may require a respondent in such proceeding to submit to consultation and monitoring by a person other than the Program Provider deemed appropriate by such hearing officer or panel or agency head.
(5) The Program Provider, its officers, employees, volunteers, designees, assignees, and subcontractors, shall not be construed as employees or servants of the Board, and no such entity, group or individual shall be construed as an agent for the Board, either expressed or implied. Any officer, employee, volunteer, designee, assignee or subcontractor of the Program Provider who represents or knowingly allows another person to believe that an agency relationship exists between the Board and the individual shall be personally liable for any damages or costs assessed or taxed to the Board which results from such representation.
(6) The Program Provider will be responsible for fringe benefit expenditures, as well as provide for office supplies, training, mileage, furniture, office equipment or anything else not specifically identified as being provided by the Board.
(7) Waiver. Any waiver of a breach of any provision of the contract shall not operate or be construed as a waiver of any subsequent breach.
Section 3. Subject Matter of Contract
As authorized by K.S.A. 65-4924, the Board agrees to pay consideration to the Program Provider, in exchange for the Program Provider's satisfactory performance of program services pursuant to this contract which shall include:
(a) Receiving investigative reports made by the Board or any other sources;
(b) Receiving reports from the Board regarding the status of a license or certificate of an individual;
(c) Initiating interventions;
(d) Assisting impaired licensees in finding evaluators and treatment programs, receiving those evaluations and implementing those recommendations as part of the monitoring process; evaluations to be accepted by the Board will document the evaluators review of Board summaries/orders/agreements with the licensee and testing including but not limited to the SASI and MMPI as part of the process for diagnosing, giving a diagnostic impression and setting recommendations for treatment and follow-up. The Program Provider agrees to supply evaluators in each case with copies of the Board Investigative Summary as well as any Board orders and or discipline documents as directed by the Board.
(e) Providing post-treatment monitoring and support of rehabilitated licensees;
(f) Monitoring the treatment or rehabilitation of impaired licensees;
(g) Assessing and referring for evaluation licensees who personally believe they are impaired and who refer themselves to the Program and licensees who are referred by the employer or other source. Providing monitoring and support services if admitted to the program for licensees referred directly by the Board whether or not evaluation has been required;
(h) Informing each impaired licensee who enters the program of his/her program responsibilities and consequences of non-compliance;
(i) Assigning a case number to each referral, which number thereafter shall be used to identify that referral;
(j) The program provider will have a person(s) responsible for oversight of the Program that possesses: at least a Bachelor's Degree with two years actual management experience or a Master's degree; at least three years experience working in psychiatric/mental health facilities; and advanced educational preparation in alcohol/drug addiction treatment. Certification in relevant areas such as drug and alcohol addictions, or psychiatric/mental health is desirable. That person(s) may be on the KNAP Board or be an employee of the subcontractor. The Program Provider will see that the person responsible for the day to day administration and work of the program, be it a subcontractor or employee of KNAP will meet the same requirements as stated above or will hold a Master’s degree in Social Work and will at a minimum possess these additional requirements: two year actual management experience; at least three years experience working in psychiatric/mental health facilities; and advanced educational preparation in alcohol/drug addiction treatment. Certification in relevant areas such as drug and alcohol addictions, or psychiatric/mental health is desirable.
(k) Recruiting, employing, or obtaining the services of other individuals as needed to provide the program services, either on a volunteer basis, or at the Program's own expense.
(l) Conducting investigations of reports received from sources other than the Board and maintaining documentation of that investigation as part of the licensee’s file. Documentation may include written documents or written or audio recording of statements by witnesses, character references and others. Such documentation shall be maintained as part of the licensee’s Program file.
(m) Verifying license number and status at the time of admission into the Program and at any subsequent renewal time during the period in which the licensee is involved in the program.
(n) Conducting an extended evaluation when there is a question of possible chemical dependency, serious concerns about diversion or use of drugs related to practice, or serious concerns regarding a participant's openness and cooperation with the evaluation.
(o) All licensee files and documentation contained therein will be maintained and stored permanently and there will be no destruction of any documentation contained therein at any time. If any licensee requests that their program file be transferred to any other referral agency or provider a copy will be transferred and the original maintained by the Program.
(p) All required reports regarding individual program participants will be made by an original writing. Electronic communications or submission of reports regarding individuals will not be acceptable under this contract based on privacy reasons.
Section 4. Reports of Impairment
(a) In all cases the Program shall receive reports regarding impairment and shall make all efforts reasonable under the circumstances to ascertain the identity of the reporting party. If not originally made in writing the program will reduce the report to writing and will maintain that documentation as part of the licensee’s Program file.
The Program Provider may proceed to refer the licensee for an evaluation/ assessment for impairment and may enter into a written agreement with the licensee to provide appropriate referral, monitoring and supportive services, subject to the following conditions:
(1) If the licensee complies with the terms of his/her agreement with the Program and the licensee is unknown to the Board, his/her participation will be reported to the Board by case number only. Licensee’s known to the Board or referred to the Program by the Board will be reported in writing by name, license number and case numbers of the Program Provider and the Board.
(2) If the licensee is non-compliant with the terms of his/her agreement, the Program Provider will report in writing the licensee's identity to the Board within five (5) working days of such noncompliance as provided in Section 6(c). The Program will report in writing the licensee's name, license number, Program case number, KSBN case number and last known address to the Board along with a statement describing the non-compliance issue. If the non-compliance issue involves a positive drug screen the Program will attach a copy of that screen to the report to the Board. If the original report of impairment also included a reportable incident, the Program will release to the Board the nature of that incident or incidents and the identity of the reporting party and all documentation in its file regarding the reportable incident.
(3) If the Program Provider receives information as a result of any contact or investigation regarding an impaired licensee who is believed to constitute imminent danger to the public or self, the Program shall report in writing the licensee to the Board as provided in Section 6(c).
(4) If the impaired licensee has previously been in an impaired licensee monitoring program whether by his/her own admission or by knowledge of the Program, the Program Provider may re-enter the licensee to the monitoring program pending the written consent of the Board. If any licensee requests to re-enter the program for the second or subsequent time, the Program will request in writing reentry from the Board prior to entering the licensee into the Program. In all such instances the Program will report the licensee's name, license number, Program case number, KSBN case number if applicable and last known address and a written statement of facts leading to the request to the Board as part of the request.
(5) If at the end of the agreement the Program has concerns about the stability of the licensee's recovery, the Program may extend the contract for up to six months without the consent of the Board. During this extension period, the Program will re-assess the licensee's recovery status. At the conclusion of the reassessment, the Program will either release the licensee or report their conclusions in writing with the individual licensee's name, license number, Program case number, KSBN case number and last know address to the Board. The Board may approve the continued extension of the contract for a specified period of time, re-contracting with the participant, or will refer the licensee for disciplinary action.