MONTGOMERY, Ala. — Alabama’s Voluntary Disciplinary Alternative Program, a voluntary program for nurses suffering with substance abuse and addiction, came under fire recently from past participants who called it “dehumanizing” and overly expensive.
“Overall, this board is one of the best boards in Alabama,” said Joseph Kreps, attorney for several nurses who had participated in VDAP, during a Sunset Committee hearing at the Alabama State House last week.
“Unfortunately, this board falls short caring for nurses suspected of addiction and mental health issues.”
While administered by third-party providers, VDAP is sanctioned by the Alabama Board of Nursing, which was one of several state regulatory boards that appeared before the Sunset Committee.
The program was established in 1994 and requires participants to undergo substance abuse treatment, monitoring and evaluations at their own cost. Upon completion, VDAP allows participants to avoid further disciplinary action, and to keep their participation in the program out of public record.
“Yes, that component has a comprehensive mental health exam, and it can also include some site testing; those things are expensive, and we cannot control what providers do and how much they charge,” said Peggy Benson, executive director of the nursing board.
Benson noted, however, that the board offers around 20 different providers, giving participants a range of different costs to choose from.
Even with the 20-or-so providers, however, Kreps argued that the organizations were largely driven by profits, contributing to the continued dissatisfaction among some VDAP participants.
“The board passes off nurses to costly, for-profit, board-approved treatment providers who push unnecessary and expensive care for the financial gain of the profit-centered treatment facilities,” Kreps said.
“Some of these treatment providers are owned by venture capitalists; venture capital has no business in addiction recovery for the professionals and the licensees of the state of Alabama. That is wrong.”
Bradford Health Services, a rehab center just north of Birmingham and one of the listed providers under the BVAP program, was acquired by Lee Equity Partners – A New York-based private equity firm – in 2022.
Another provider owned by a parent company that operates under a private equity model of acquiring assets is Ridgeview Institute in Jasper, acquired by US HealthVest in 2017.
The dissatisfaction among BVAP participants was documented in the Nursing Board’s audit report from between 2019 and 2023. That report included 220 complaints from nurses about the program.
Some nurses, such as Abby Vinson, attended the hearing in person to speak to their experience undergoing the program.
“When I sought help from the Board of Nursing, I was treated more like a criminal, not a professional,” Vinson said.
“Despite having no history of endangering patients or criminal activity, I was forced into a $5,000 assessment, and then told by the treatment facility I had to pay upfront for a 90-day inpatient rehabilitation service that is zero-percent covered by my health insurance, which I had to obtain privately since I lost my job.”
Vinson went on to say that she was “made to” take sedating medication during her time in the program, was “forced into lower-paying shifts,” that her participation in the program was factored into her annual performance review, thereby violating the program’s privacy clause, and that the entire experience was “dehumanizing.”
Tyanna Arroyo, another participant in the program, also described the experience as dehumanizing, and said that she was forced to borrow $18,000 and spend thousands on drug testing therapy, which she called “outrageously expensive and unrealistic.”
“I fully accept responsibility for my past actions and consequences; what I didn’t expect was to feel disrespected, dehumanized, and treated less than a person,” Arroyo said.
“The financial, emotional and mental toll of being on a monitoring program nearly made me walk away from my calling in nursing entirely.”
While admitting that the process was expensive, Benson stood behind it as among the best in the country, and touted that it met all national standards for rehabilitation programs.
Hearing the accounts of the two nurses, Sen. Garlan Gudger, R-Cullman, told Benson that he would like to continue conversations regarding the BVAP, noting that the costs were “a lot of money.”