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Substance Abuse, Impairment, HPRP — and Your License: What Michigan Licensed Healthcare Providers Need to Know

Medial Professional Drinking Beer Behind the Steering Wheel of a vehicle.

What is the HPRP?

The Health Professionals Recovery Program (HPRP) is a designated Impaired Practitioner Program for Michigan-licensed healthcare professionals.

It was originally designed as a means of protecting individuals, who wish to receive confidential treatment and monitoring for a substance abuse or mental health concern, from suffering a negative impact on their professional license.

In its present form, it is the clearing house for the Department of Licensing and Regulatory Affairs (LARA), Bureau of Professional Licensing, regarding any allegations of impairment concerning any licensed healthcare professional — including physicians, nurses, dentists, osteopathic specialists, optometrists, and veterinarians — and it determines whether that professional needs to enter a monitoring/treatment program per an evaluator’s assessment.

Why Did My Employer Refer Me to HPRP?

Michigan-licensed healthcare professionals are most often referred to HPRP by employers due to potential safety-to-practice concerns. These concerns can stem from matters involving substance abuse, criminal charges, mental instability, or other psychiatric or physical conditions that could put public safety at risk.

However, referral to HPRP most often follows a termination of employment of a health professional for issues related to alleged diversion or impairment, which results in mandatory reporting by the employer to LARA within 30 days.

How Does Someone Enter HPRP?

Physicians, nurses, and other health professionals enter HPRP by way of a monitoring agreement. This is a contract specifying terms of treatment by which the individual must abide. Health professionals can be referred to HPRP two different ways: a “non-regulatory” referral, and a “regulatory” referral.

What is a Non-Regulatory Referral?

A non-regulatory referral includes individuals who self-report to HPRP and those who are offered a non-regulatory status as part of an agreement with HPRP.

It is called non-regulatory because the names of individuals participating in the HPRP may not be given to the public or to the state, so long as the individual meets the program requirements. However, if you fail to abide by even one aspect of the contract over the term of the contract (which is often as long as three years), you will be reported to the state as “non-compliant.”

What is a Regulatory Referral?

Physicians, nurses, and other health professionals may receive a regulatory referral as a result of a regulatory action taken on an individual’s license by their profession’s board or disciplinary subcommittee. Regulatory referrals are not confidential, and your participation may be reported to your place of employment, a court, or in accordance with the Freedom of Information Act.

Who Determines Whether I am Ultimately Enrolled in HPRP?

Prior to being offered a monitoring agreement, HPRP will send you to an evaluator to determine if you suffer from impairment due to substance abuse or mental illness. The evaluator will ask questions about your medical history, your family’s medical history, your history with drugs/alcohol, whether you have been in substance abuse treatment programs before, and the likes. It is vitally important to prepare for this evaluation ahead of time in order to be prepared for the questions that will be asked.

(As an Example,) I Was Slightly Intoxicated When I Showed Up at Work on the Day In Question. This Was an Isolated Incident, and I Don’t Actually Have a Drinking Problem, But the Evaluator Still Determined I Should Be in HPRP. Why?

HPRP evaluators are medical practitioners themselves, and they serve as not just agents of HPRP, but also that of individual practitioners. They do not need to assess the existence of an actual diagnosis; they simply need to assess risk. In your case, your evaluator saw the potential for risk given his/her professional medical background as well as HPRP standards.

What If I Say No to HPRP?

If you choose not to follow through with evaluation, treatment, the recommendations of the HPRP or any authorized provider, or refuse to sign a monitoring agreement, the HPRP is required to send your name to the Department of Community Health, Bureau of Health Professions, and your information will no longer be confidential — even if you self-reported.

Will Going Into HPRP Prevent Action Against My License?

Not necessarily. If, after evaluation, the evaluator believes you are unsafe to practice, a summary suspension order could be placed on your license if you do not agree to enter a monitoring agreement. This means you will not be able to practice until the order is lifted, if at all. Also, there are instances in which an administrative complaint will be filed even after entering into HPRP as a non-regulatory referral if the allegations are related to diversion of controlled substances.

If I Don’t Enroll in HPRP, Does That Mean I’m Immediately Suspended?

No. Suspension is a determination from your board (i.e., Board of Nursing, Board of Medicine), not HPRP, to make.

How Else Can My License Be at Risk?

After an evaluation, the evaluator may find that you are high risk and unsafe to practice, and he/she could recommend you do not return to work until you are safe to practice. While this is a recommendation, if you fail to comply with it, you will be reported to the Department of Community Health, Bureau of Health Professions, and you will likely face summary suspension of your license.

Can I Still Look for Other Work While My Case is Under Investigation?

Unless you were placed on an emergency suspension order and are on immediate suspension, you can apply for other jobs. 

What Are the Advantages of Enrolling in HPRP?

HPRP was designed as a voluntary intervention alternative to the disciplinary process administered by LARA and your respective professional board. By being compliant with the monitoring agreement, you may stand a better chance at having your license maintained than putting your case before your board.

However, each case must be evaluated on its own unique set of facts and whether non-regulatory entry into HPRP will truly protect your license or not. 

What Are the Disadvantages of Enrolling in HPRP?

The typical outcome for HPRP enrollment is being put under, and complying with, a monitoring contract. These contracts can be for 2-5 years, and you will be under strict orders to comply.

You will have to pay out-of-pocket for all costs involved in monitoring, such as urine toxicology screening, ongoing psychotherapy, and fees for the facilitator of the group you attend as a requirement of your contract. Participants report that they spend up to $30,000 of their own money through the course of a three-year monitoring agreement.

In addition, a multiyear monitoring agreement with HPRP does not guarantee you will be in the clear: action still can be taken against your license.

How Long Can Board Investigations Into My Case Take?

Investigations can take 6-7 months, and sometimes up to two years. However, if LARA believes that you are “an immediate threat of serious harm to the public,” you may be placed on an emergency summary suspension order.

Why Should I Call Chapman Law Group Before I Contact HPRP?

Because the healthcare licensing attorneys at Chapman Law Group have decades of experience in helping nurses and medical practitioners avoid HPRP enrollment and formal licensing action, as well as specialized knowledge regarding the specific evaluators, the HPRP intake and evaluation process, and the ability to challenge adverse evaluation findings within the HPRP system.

Our lawyers are experienced in helping nurses and practitioners resolve allegations of drug diversion, positive drug screens, DUIs, and other impairment matters.

We use three factors when helping nurses decide whether HPRP is a good option for avoiding licensing action:

    1. Do you have an alcohol or drug addiction?
    2. Is this your first offense?
    3. Are you able to prove to the relevant board that:
      • this was an isolated situation;
      • you are safe to practice;
      • you would not benefit from a period of monitoring; and
      • you do not need active supervision?

Chapman Law Group is prepared to work through these critical steps with you and, if possible, prove to the relevant board that you are capable of continuing without an intervention.

We strongly advise you to not reach out to HPRP without first discussing your options with us. Our lawyers can prepare your defense and negotiate options before licensing action commences and HPRP evaluation is made a mandatory condition for continued licensure.

Need an attorney? Contact us now!

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Aaron J. Kemp

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Chairperson of Professional Licensing & Regulatory Affairs

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Troy, MI 48098
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