Nursing Licensure and the Indiana State Nurses Assistance Program

August 29, 2022

By Keffer Hirschauer LLP

The Indiana State Nurses Assistance Program 

ISNAP or the Indiana State Nurses Assistance Program is a state-wide substance abuse monitoring program for nurses. It’s currently managed by the Indiana Professionals Recovery Program (IPRP) and is funded by the Board of Nursing and the Indiana Professional Licensing Agency (PLA). This program is designed to support Indiana nurses who struggle with substance abuse while allowing them to continue working in the field of nursing. The Indiana State Nurses Assistance Program provides nurses with valuable resources for recovery and equips them with the skills necessary to continue working and remain abstinent.  

While many nurses who have engaged the services of ISNAP in Indiana have done so through self-reporting, others have entered the program through regulatory referral. This often means that they encountered a legal problem, such as diverting medication or being charged with a DUI, and must participate in the program to either regain or maintain their nursing license.  

If you’re a nurse who has been charged with an OWI in Indiana or an Indiana drug crime, the Indiana Board of Nursing Attorneys at Keffer Hirschauer LLP can work to clear your name and protect your career. Using exceptional litigation skills acquired through decades of work as trial lawyers, we understand what your professional license means to you and what it takes to defend your license. If you’ve been referred to ISNAP in Indiana due to an alleged violation or a complaint filed against your nursing license, call Keffer Hirschauer LLP today at 317-648-9560 or schedule a free, confidential consultation. We can help you understand your situation and discuss the best steps moving forward.  

Indiana Health Professions Standards of Practice 

Indiana nurses who are regulatory referrals to the Indiana State Nurses Assistance Program often have encountered a legal problem or complaint that conflicts with their adherence to the Indiana Health Professionals Standards of Practice. This set of standards is wholly aimed at preventing patient harm, therefore nurses found in violation may face discipline by the Indiana State Board of Nursing for failure to meet the standard of care. 

Per Indiana Code 25-1-9-4, prohibitions within the Indiana Health Professionals Standards of Practice include:  

  • Engaging in fraud or material deception in providing professional services or related activities 
  • Being convicted of a crime or assessed a civil penalty for fraudulent billing practices 
  • Being convicted of a crime with a direct bearing on the practitioner’s ability to continue to practice competently or one that is harmful to the public 
  • Knowingly violating any federal or state statute, rule, or regulation regulating the profession in question 
  • Continuing to practice after becoming unfit to practice due to professional incompetence 
  • Failing to keep abreast of current professional theory or practice 
  • Being addicted to, abusing, or having a severe dependency on alcohol or other drugs that endanger the public by impairing a practitioner’s ability to practice safely 
  • Engaging in lewd or immoral conduct in connection with the delivery of services to the public 
  • Diverting a legend drug 
  • Prescribing or administering any drug classified as a narcotic, addicting, or dangerous to a habitue or addict 
  • Engaging in sexual contact with a patient under the practitioner’s care 

As you may be able to tell, some of these prohibitions are written in a broad manner, meaning that they can be interpreted in different ways. Therefore, a complaint made against a licensed nurse, or a perceived violation may or may not support the finding of a violation of one of these professional standards. For example, simply being convicted of a crime doesn’t necessarily threaten a nurse’s license. However, if that crime has a direct bearing on a nurse’s ability to practice in a competent manner, then the license may be at risk.  

If you are a licensed nurse in Indiana and find yourself convicted of a crime or subject to a complaint, it is vital to retain the counsel of a professional license defense attorney. They can help you make the case that your conviction or complaint does not impact your ability to practice nursing in a competent manner. If successful, this may negate your regulatory admission to the Indiana State Nursing Assistance Program (ISNAP) and/or protect your ability to practice nursing in Indiana. If you’d like to speak with an attorney today, call Keffer Hirschauer LLP at 317-648-9560. 

Reporting Violations to the Indiana Board of Nursing and/or ISNAP

Most violations of the Indiana Health Professionals Standards of Practice will come to the attention of the Board of Nursing or the Office of the Attorney General via mandatory reporting at the time of the incident. However, they may also come to the Board’s attention via the Indiana Nursing License renewal application. Every two years, nurses in Indiana are required to renew their Indiana Nursing License. In doing so, they are required to answer six questions regarding potential violations of Indiana Health Professionals Standards of Practice.  

  1. Since your last renewal, has any health professional license, certificate, registration, or permit you hold or have held been disciplined, or are formal charges pending?  
  2. Since you last renewed, have you been denied a license, certificate, registration, or permit in any state?  
  3. Since you last renewed, and except for minor violations of traffic laws resulting in fines and arrests or convictions that have been expunged by a court, have you been arrested, entered into a diversion agreement, been convicted of, pled guilty to, or pled nolo contender to any offense, misdemeanor, or felony in any state?  
  4. Since you last renewed have you had a malpractice judgment against you or settled a malpractice action?  
  5. Have you been reprimanded, disciplined, demoted, or terminated in the scope of your practice or as another health care professional?  
  6. Since you last renewed have you been excluded from being a Medicare or Medicaid provider?  

Answering “yes,” to any of these questions (or providing a false answer) will require the nurse to make a personal appearance in front of the Indiana Board of Nursing. If the board finds that the violation has a direct bearing on their ability to practice in a competent manner, they can propose numerous types of discipline, based on the severity of the violation.  

Self-Reporting to the Indiana State Nurses Assistance Program 

Nurses who are struggling with a substance abuse disorder may choose to proactively contact Indiana State Nursing Assistance Program for assistance, treatment, and monitoring. This is classified as voluntary admission into the program and allows nurses to continue being active in their careers, provided that they remain compliant with the program.  

Nurses who pursue voluntary admission into ISNAP are often able to obtain confidential help, resulting in little to no effect on their licensing status. However, confidentiality is only available to nurses who self-report to ISNAP prior to a terminating violation, positive drug screen, or the filing of a consumer complaint.  

Indiana State Board of Nursing Disciplinary Actions 

When a nurse is found to be in violation of the Indiana Health Professionals Standards of Practice, The Indiana Board of Nursing can impose a variety of penalties. Per Indiana Code 25-1-9-9, these penalties include:  

  • Permanent revocation of license 
  • Suspension of license 
  • Censure of the licensee 
  • Written reprimand of licensee 
  • Placement of the licensee on probation 
  • Assessment of a civil penalty of not more than $1,000 per violation 

Nurses whose license has been put on probation or suspended for substance abuse-related violations may be required to participate in the Indiana State Nurses Assistance Program (or ISNAP). Nurses in ISNAP are often subject to a one to three-year-long Recovery Monitoring Agreement (or RMA). The RMA outlines the conditions of the nurse’s participation in ISNAP and could include mandatory drug and alcohol testing, counseling, or other treatment services.  

Common Violations That Lead to Participation in the Indiana State Nurses Assistance Program

The most common violations that lead to a nurse’s mandatory participation in the Indiana State Nurses Assistance program are workplace impairment or intoxication, a positive drug screening, or an alcohol-related conviction, like an OWI. Nurses may also face mandatory ISNAP participation for violations like diversion of medication, improper administration of narcotic drugs, a consumer complaint related to substance abuse, or a drug-related conviction, like possession of a scheduled drug.

Facing Discipline from ISNAP and/or the Indiana Board of Nursing? 

The Indiana Board of Nursing has the power to levy harsh disciplinary actions against nurses found in violation of Indiana Health Professionals Standards of Practice. These actions can have a profoundly negative impact on both your financial and professional health and cause significant hardship for both you and your family. To protect your career and livelihood, it is vital that you engage an experienced Indiana Board of Nursing attorney as early in the process as possible, ideally right after the alleged violation occurred. 

The professional licensing attorneys at Keffer Hirschauer LLP will fight tirelessly to protect your license and career. Our team will ensure a fair process in front of the Indiana Board of Nursing, promote a vigorous investigation of the claims against you, and provide a robust argument in your defense. If you have questions about professional licenses or would simply like to speak with an attorney today, call us at 317-648-9560 or schedule a free, confidential consultation 

 

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