Michigan’s Health Professional Recovery Program (HPRP) provides support services for licensed health care professionals in the state who struggle with substance abuse, drug dependence, and mental illness. Although the HPRP is a state program, it is currently administered by a private contractor, Ulliance Health, Inc. The HPRP’s stated mission is to help health care providers who might be at risk of losing their license (in addition to facing obvious health consequences) due to addiction or mental illness. However, you would be wise to keep in mind that entering into an HPRP monitoring agreement can have negative ramifications for licensed professionals. So any physician, nurse, or other professional who is considering HPRP enrollment should first seek advice from an experienced health care law attorney.
For example, in 2015 a group of licensed health care professionals in Michigan filed a class action lawsuit against the HPRP alleging that the program subjected providers to excessive and unnecessary treatment, and that providers risked suspension of their professional licenses if they did not comply. In the lawsuit, the plaintiffs alleged that the program was being operated not so much as a voluntary substance abuse treatment program, but rather as a punitive measure targeting physicians and other providers who sought (or were forced to seek) help. Specific allegations included subjecting licensed professionals to long-term substance abuse treatment based solely on anonymous tips, and forcing professionals to choose between paying tens of thousands of dollars for unnecessary treatment or having their licenses suspended. The latter was allegedly the case for both health care professionals who voluntarily enrolled with the HPRP (or “self-reported”) and those who entered the program as a result of disciplinary action (also known as a “regulatory referral”).
Michigan’s Health Professional Recovery Program: How it Works
Enrollment into the HPRP can be triggered by one of two events: A licensed health care professional can self-report to the HPRP after an incident involving substance abuse, chemical dependency, or mental health, or a provider can receive a regulatory referral as a result of disciplinary action involving an incident. Once a professional enrolls, they must choose an evaluator from a list. Then they are given an evaluation, after which the evaluator makes treatment recommendations.
The evaluator’s recommendations can lead to two potential consequences. If the evaluator determines that the professional is qualified to continue in his or her practice, the HPRP will prepare a monitoring agreement based upon the evaluator’s recommendations. This could involve invasive, long-term, and expensive treatment many providers are forced to spend upwards of $30,000 and the consequences of non-compliance can be severe. If, however, the evaluator determines that the professional is “unsafe to practice,” the evaluation can result in immediate disciplinary action (even in cases of self-reporting), and licensed professionals can face immediate summary suspension.
During the entire time that a licensed professional is subject to a monitoring agreement, he or she must maintain strict compliance with the evaluator’s recommendations. In addition to participating in ongoing treatment, this may include requirements such as seeking approval for vacations and being under the constant watch of a worksite monitor. Any violation of a professional’s monitoring agreement for any reason (including an inability to cover the costs of treatment) can result in disciplinary action equal to that faced by a professional who is deemed “unsafe to practice.”
Answers to FAQs: Michigan’s Health Professional Recovery Program
Q: I am a physician or nurse in Michigan and I have experienced a personal incident involving substance abuse, chemical dependency, or mental health. Should I self-report to the HPRP?
Maybe, but not until you discuss your options with your attorney. While it may seem like a good idea to self-report, once you initiate the HPRP process, it can be extremely difficult to extricate yourself without facing substantial financial liability or loss of your professional license. You may also have better, less-costly, and less-risky alternatives available.
Additionally, it is important to note that, while your voluntary enrollment in the HPRP will remain confidential as long as you comply with the program’s requirements (including the obligations under your monitoring agreement), if you violate the terms of your enrollment, the HPRP can report you to the Department of Community Health, Bureau of Health Professions, and your license will be in jeopardy.
Q: Will my employer find out if I self-report or receive a regulatory referral to the HPRP?
If you self-report to the HPRP, your employer should not find out unless: (i) you disclose your enrollment, or (ii) you lose your license due to non-compliance. However, if you receive a regulatory referral as a result of a disciplinary ruling, your referral is not confidential. Regulatory referrals can be reported to employers, and they can be made public through the court system or Michigan’s Freedom of Information Act (FOIA).
Q: What if I self-report to the HPRP and then change my mind about going through with the evaluation?
If you self-report but then decide not to go through with the mandatory evaluation, the HPRP is required by statute to report your case to the Department of Community Health, Bureau of Health Professions. At this point, your self-referral will no longer be confidential. The same is true if you either: (i) refuse to sign a monitoring agreement following an evaluation; or, (ii) choose not to follow through with treatment based on the evaluator’s recommendations.
Q: What if I am uncomfortable with the terms of my HPRP monitoring agreement?
When you read your HPRP monitoring agreement, you are likely to see numerous provisions that make you uncomfortable. For example, it is typical for an HPRP monitoring agreement to require regular drug tests and breathalyzers, individual and group counseling, worksite monitoring, practice restrictions, and prescription medication approval requirements.
While it is possible to negotiate certain provisions of an HPRP monitoring agreement, the program views many of these provisions as “standard” and “non-negotiable.” Before you sign and, if possible before you self-report to the program you will want to speak with an attorney who knows what terms you are likely to be able to negotiate in your monitoring agreement.
Q: What if I disagree with the evaluator’s recommendations?
Once you go through an HPRP evaluation, you have very little recourse with respect to challenging the evaluator’s recommendations. However, you have the right to choose your evaluator from a list of options, and it is imperative that you research each of the potential evaluators so that you can make an informed decision about the professional who will be making decisions that impact your ability to practice medicine in Michigan.
While negotiating your monitoring agreement, you will have some ability to limit the scope of your obligations to comply with the evaluator’s recommendations. But, once again, your options are likely to be limited, and you will need to hire an experienced attorney who can help mitigate your risk as much as possible.
Q: How long does an HPRP monitoring agreement last?
A monitoring agreement with Michigan’s Health Professional Recovery Program can last as long as three years. If you violate any of the terms of your agreement at any time prior to its expiration, you can face disciplinary action, including possible license suspension.
Q: How much does it cost to go through the Health Professional Recovery Program?
Many health care professionals in Michigan have been required to spend as much as $30,000 to meet their obligations under the HPRP. This includes professionals who self-reported and those who received regulatory referrals. Costs that HPRP enrollees must incur pursuant to the terms of their monitoring agreements include:
- Drug testing
- Group counseling sessions
- Therapy sessions
- Treatment costs
- Costs of collection
If you are unable to pay the costs of participating in the HPRP, you will be deemed “non-compliant” and referred to the Department of Community Health, Bureau of Health Professions for disciplinary action.
Q: Does Michigan’s Health Professional Recovery Program work for anyone?
According to HPRP’s website, yes. The program’s website includes testimonials from medical doctors, nurses, pharmacists, dentists, veterinarians, and other practitioners, and states that the HPRP “supports the recovery of its participants so they may safely return to practice and protect the safety of the general public.” If you are struggling with a substance abuse problem or mental health issue, the HPRP may be able to help; but you should consult with your attorney and explore other options as well.
Q: What type of attorney can help me make decisions about the HPRP?
Just as licensed medical professionals specialize in different areas of medicine, attorneys focus their practices in different areas of the law. In order to assess your options with regard to the HPRP, it is important that you choose an attorney who has specific knowledge and experience regarding Michigan’s health care laws and regulations. At Oberheiden, P.C., we have decades of experience representing health care providers in Michigan and nationwide, and we can help you make informed decisions about the HPRP.
Contact the Detroit, MI Office of Oberheiden, P.C.
If you would like to speak with an attorney about Michigan’s Health Professional Recovery Program, we encourage you to contact our Detroit, MI office for a free consultation. To speak with an experienced health care attorney in confidence, please call (313) 888-8807 or send us a message online today.