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Early Termination or Adjustment to IPN Contracts

Florida’s Intervention Project for Nurses (IPN) was established by legislation enacted in 1983. However, IPN is not a State of Florida agency; rather, it is an independent organization that acts as a liaison between the Florida Board of Nursing (BON), the Department of Health (DOH), treatment providers, and impaired nurses.

IPN’s stated mission is to ensure public health and safety by providing an avenue for swift intervention, close monitoring and advocacy of nurses whose practice may be impaired due to the use, misuse or abuse of alcohol or drugs, or a mental and/or physical condition1.

Most nurses are satisfied with IPN’s services, but others become unhappy with the program and want to leave or adjust their commitments. There are many reasons why nurses become discontented with IPN including cost, time commitment, or a belief that they have been fully rehabilitated. As a result, nurses frequently seek legal advice about obtaining an early release from or adjusting their IPN contracts. The following questions will provide you with some things to consider.

I. I am unhappy with my IPN contract. Is it possible to terminate the contract early?

While it is possible to terminate your IPN contract early, it not easy to do so and there are very few ways for you to do so without penalties. In most instances it is not possible to leave IPN after signing a contract without surrendering your nursing license. There can be adverse consequences to surrendering you license, including a report to the National Practitioner Data Bank (NPDB), exclusion from the Medicare and Medicaid Programs, and debarment from federal government contracting2.

One of the ways to avoid discipline for early IPN contract termination is by demonstrating “good cause.” The governing Florida statute requires “good cause” for terminating a treatment program for impaired practitioners3. This statute applies to nurses in the IPN program as well as other healthcare practitioners, such as physicians, dentists and pharmacists who have contracted with a program similar to IPN called Professionals’ Resources Network (PRN).

Due to the harsh consequences of terminating an IPN contract, you should consider speaking with an experienced professional licensing attorney before signing or breaking an IPN contract. The experienced attorneys of Chapman Law Group are always available to assist.

II. What is “good cause?”

“Good cause” is a statutory (legal) reason for early termination, without penalty, from an IPN contract. Unfortunately, the Florida legislature has not defined the exact meaning of the term “good cause.” But in general “good cause” means a legally sufficient reason4.” Therefore, we must resort to case law interpretations of “good cause” to determine its legal meaning.

III. What do you mean by case law interpretations of “good cause?”

“Good cause” is a statutory (legal) reason for early termination, without penalty, from an IPN contract. Unfortunately, the Florida legislature has not defined the exact meaning of the term “good cause.” But in general “good cause” means a legally sufficient reason .” Therefore, we must resort to case law interpretations of “good cause” to determine its legal meaning.

III. What do you mean by case law interpretations of “good cause?”

Since the term “good cause” is not specifically defined by Florida statues, it is effectively left up to judges to determine the meaning of the term. Therefore, we must look at reported court cases where the term “good cause” was discussed by judges to determine what they consider it to mean.

IV. So, what have judges interpreted “good cause” to mean?

The frequently cited examples of “good cause” from case law are “death, active military duty, or documentation from a physician that a nurse could never practice again because of a disabling medical condition5.” These examples of “good cause” sound extreme, but they are the only ones we have from case law. Nonetheless, the “good cause” standard is very high and hard to meet.

V. Does the IPN Participant Manual say anything about “good cause” contract termination?

The twenty-nine page participants’ manual contains no guidance on how a participant may early terminate an IPN contract for good cause or otherwise. Instead, the manual is focused upon acts or omissions indicating non-compliance, grounds for IPN to terminate a participant’s contract, and penalties for violations. Notably, there is a section for filing grievances with IPN which states that grievances are decided upon by IPN.

VI. I do not think that IPN is helping me; shouldn’t that be “good cause” to terminate my contract?

In a recent case a nurse argued for early termination of her IPN contract because she “did not want to be in the program because she did not feel that the program had anything to offer her6.” A judge ruled that this nurse’s reasons for not complying with her IPN contract “did not constitute good cause for failing to comply with the terms of her contract.”

VII. Could there be other reasons for “good cause” besides the examples from case law?

Yes, it is possible that there are additional ways to establish “good cause.” For example, reasons like financial hardship or successful rehabilitation might be reasons for adjustment or termination of your IPN contract. Unfortunately, those reasons have not been tested in the courts by IPN participants. Thus, other sufficient reasons for “good cause” may exist, but they certainly must be argued in a hearing such that they could be considered by a judge.

VIII. Are there other reasons for terminating IPN besides “good cause?”

Your IPN agreement is a legally binding contract and the law disfavors the unilateral termination of contracts. Therefore, if you terminate your IPN contract without permission, you will be in breach of contract and subject to BON penalties unless you can establish a valid affirmative defense for your breach. Standard affirmative defenses for breach of contract include fraud, duress, mistake, substantial compliance, and illegality.

For example, if you were told you needed to sign an IPN contract because the IPN evaluator concluded that you had an addiction problem, but in actuality your evaluation showed that you did not have problem, then you could argue the affirmative defense of fraud. A judge would have to determine if you were fraudulently induced into signing the IPN contract.

IX. I’ve nearly completed my IPN contract; shouldn’t this be enough for substantial compliance?

To argue the affirmative defense of substantial compliance, you would likely need to complete almost the entirety of your IPN contract and have no violations during the period of the contract.

In a recent case a nurse argued that “her compliance for approximately three years of her five-year contract should be considered substantial compliance7.” The judge ruled that a substantial compliance defense was without merit because 20 percent of her urine specimens were too diluted for monitoring purposes; she resisted testing to determine why the urine screens were diluted; and she no longer followed the requirements of the program. The judge decided that the nurse’s behavior was inconsistent with the claim of substantial compliance.

Although the nurse in this case could not demonstrate substantial compliance, the fact that the judge considered it as a potential defense indicates that substantial compliance might justify early termination of an IPN contract.

X. I don’t appear to have either “good cause” or an affirmative defense. But, what if I go ahead and terminate my IPN contract anyways?

There are severe penalties for terminating you IPN contract. You should never terminate you contract early without speaking to a qualified Florida professional licensing attorney.

If you terminate your IPN contract the DOH will almost certainly file an administrative complaint against you alleging that your unprofessional conduct8 violated Florida statute because you failed to comply with the terms of an impaired practitioner’s monitoring or treatment contract.

A professional licensing attorney can assist you with all aspects of your IPN contract. Chapman Law Group’s professional licensing attorneys are available to answer any of your questions and to provide legal assistance when necessary.

References

1. http://www.ipnfl.org/
2. Florida Nursing Law Manual, Ch. 19, p. 5, Indest, (2008)
3. Florida Statue § 456.072 (1) (hh) (2013)
4. Black’s Law Dictionary
5. Dept. of Health, Board of Nursing vs. Elwell, L.P.N., R.N., Fla. Div. Adm. Hearings, Case No. 11-6177PL (2012)
6. Dept. of Health, Board of Nursing, vs. Cassel, R.N., Fla. Div. Adm. Hearings , Case No. 08-2106PL (2008).
7. Dept. of Health, Board of Nursing v. Cunningham, R.N., Fla. Div. Adm. Hearings, Case No. 09-0611PL (2009)
8. Section 464.018(1) (hh), Florida Statutes (2013)