Developing Best Practices for a Healthcare Professional Recovery and Monitoring Program

The Massachusetts Department of Public Health (DPH), through its Bureau of Health Professions Licensure (BHPL), sought to establish the Unified Recovery and Monitoring Program (URAMP), a new alternative-to-discipline program for licensed healthcare professionals with substance use and mental health conditions. State legislation expanded the program's scope from serving nurses and pharmacists with substance use disorders to supporting professionals across all 21 BHPL-regulated health professions and a broader range of mental health conditions. DPH needed evidence-based guidance on participant admission, evaluation, monitoring, support, return-to-work, and discharge processes that would ensure public safety, regulatory compliance, consistency, and equitable access to services. To support implementation, DPH sought a comprehensive assessment of national best practices on managing healthcare professionals with mental health conditions.

ERG led a national mixed-methods assessment to identify best practices for monitoring and supporting healthcare professionals with non-substance-use-related mental health conditions. ERG reviewed laws, regulations, and operational practices across 74 professional health programs in 46 states; interviewed representatives from 15 recovery and monitoring programs and five nationally recognized clinical experts; and examined program models, staffing, funding, admission criteria, monitoring approaches, and return-to-work practices. ERG also evaluated equity considerations and barriers to participation, including the financial burden of evaluations, treatment, and monitoring requirements. ERG synthesized findings into 17 actionable recommendations and supporting tools to guide participant admission, clinical and fitness-for-duty evaluations, monitoring requirements, workplace accommodations, program governance, staffing, outreach, and equitable access to services. The resulting framework provided DPH with evidence-based guidance for implementing URAMP across all regulated BHPL health professions.