OUR PROCESS

FOR PROSPECTIVE PARTICIPANTS

To refer yourself or someone else to our program, complete our Referral Form. If additional assistance is needed, please call us at 701.751.5090 or email us at info@ndphp.org.

ENROLLMENT PROCESS

This is a general description of our enrollment process. For more specific information, contact us.

Participant Confidentiality Agreement

Introduction:

Thank you for your interest in the North Dakota Professional Program (NDPHP). Before you decide to participate, it is essential that you fully understand the program’s purpose, services, and the expectations placed upon you as an active or potential participant. Further, this Agreement is intended to explain the confidentiality practices and limitations associated with the eligibility determination process for NDPHP. Please carefully review this consent form, and do not hesitate to seek clarification on any points before proceeding.

Purpose of NDPHP:

NDPHP is an independent 501(C)(3), nonprofit organization. NDPHP offers a confidential alternative to discipline, by providing assistance to licensed professionals who may be facing challenges due to substance use disorders, mental health illnesses, burnout, boundaries, competency, or fitness for duty.

NDPHP is committed to providing assistance to licensed professionals in an atmosphere free from discrimination.  NDPHP does not discriminate against any individual seeking assistance or any participant on the basis of race, color, religion, sex (including gender identity and sexual orientation), national origin, age, disability, status with regard to marriage, receipt of public benefits, veteran status, or any other characteristic protected by federal, state, or local laws. NDPHP is dedicated to creating a diverse and inclusive environment where everyone is treated with respect and dignity.

Scope of Services:

The NDPHP does not provide clinical services or treatment.  Instead, the program offers resources, referrals for clinical evaluations and treatment, and continuous monitoring of your recovery process. The goal of NDPHP is to support your well-being and your capability to practice safely and effectively.

Participant Requirements:

If you are eligible for the services provided by NDPHP and choose to participate, you will be required to fulfill a range of responsibilities and requirements that may include some or all of the following: a) comprehensive clinical evaluations, b) recommended treatment, c) random toxicology testing, d)scheduled contact with NDPHP, e) attending support group meetings,      f) work-site monitoring; g) abstinence from substances and h) other required activity or activities that promote your success in the program.

You will also be responsible for the costs of these services. The average length of monitoring is 5 years or less.

Voluntary Participation:

Whether participation in NDPHP is based upon a self-referral or an order from a professional licensing board, the decision to enter the program and comply with all requirements is voluntary. If you choose to engage with NDPHP, you will be expected to adhere to the program’s requirements and guidelines. While participation is voluntary, it’s important to recognize that NDPHP can offer you an opportunity to seek confidential assistance for substance use and mental health disorders.

Rights and Responsibilities:

• The right to voluntary participation in NDPHP.
• The right to withdraw from participation in NDPHP at any time.
• The responsibility to:
  • Promptly notify NDPHP if you receive notice from your licensing board of a disciplinary complaint filed or a malpractice or other legal action has been served to you.
  • Promptly notify your professional licensing board that you are participating in NDPHP if any disciplinary action has been taken against your professional license.
  • Promptly notify NDPHP if you receive notification of an investigation by a state or federal licensing, regulatory or law enforcement agency involving your professional license.

Confidentiality, Legal, and Limited Disclosure during NDPHP Eligibility Determination & Participation:

During the process of determining your eligibility for participation in the NDPHP, it is important to emphasize that your interactions with the NDPHP are confidential. The confidentiality extends to the information you share with us as a part of the eligibility assessment.

However, under state and federal law, there are specific circumstances under which the NDPHP is legally obligated to notify a professional licensing board. These circumstances include, but are not limited to the following:

• NDPHP determines that a professional is or may be impaired and believed to constitute an imminent danger to the public or yourself.
• A professional reports knowledge of a child, elderly person or vulnerable adult being abused or neglected
• NDPHP determines that you have declined treatment recommendations, and no acceptable alternative has been identified and agreed upon.
• It has been determined that a professional is unsafe to practice and after being notified by NDPHP the professional continues to practice.
• NDPHP determines that a professional may have has violated legal or ethical obligations as a licensed professional and harmed a patient, a client or a third-party.
• A professional is non-compliant with the monitoring agreement at the NDPHP or with any other out-of-state licensing boards and/or monitoring programs.
• A professional self-reports or has been referred for misconduct and refuses to participate in evaluations or treatments recommended by the NDPHP and/or has been deemed ineligible for the program.