4.4 Impaired Practitioners & the Health Professionals' Services Program (HPSP)
Key Takeaways
Oregon's HPSP monitors licensees diagnosed with substance use or mental health disorders. It does not diagnose or treat.
A self-referred Oregon pharmacist must attest they are not under Board investigation. HPSP reports a self-referral to the Board only if the licensee is noncompliant.
Oregon HPSP monitoring agreements require at least two years of continuous compliance, random testing, abstinence, practice limits and payment by the licensee.
Under an HPSP agreement, a licensee reports prohibited substance use within 24 hours and any arrest or conviction within three business days.
HPSP must report substantial noncompliance, such as a positive test or impairment at work, to the licensee's board within one business day.
Why this matters
The blueprint asks about "reporting to and participating in programs addressing the inability to practice with reasonable skill and safety." In Oregon that program is the Health Professionals' Services Program (HPSP), the impaired health professional program authorized by ORS 676.185 to 676.200. The Board of Pharmacy participates under OAR 855-011. Questions test self-referral versus Board referral, what HPSP reports to the Board and when, and what a monitoring agreement requires.
What HPSP is, and what it is not
- HPSP monitors licensees who have been diagnosed with alcohol or substance abuse or a mental health disorder that can impair practice (ORS 676.190(2)(a)).
- HPSP does not diagnose or treat. Independent clinical evaluators diagnose, and treatment providers treat (ORS 676.190(5)).
- It is a monitoring program built on a written monitoring agreement. It is not an amnesty program. The Board keeps its authority to discipline.
Impairment itself is a ground for discipline (ORS 689.405(1)(d), using the ORS 676.303 definition). The Board can also order a mental, physical, chemical-dependency or competency evaluation at the licensee's expense when it has objectively reasonable grounds (ORS 689.135(10)).
Two routes into HPSP
| Feature | Board referral | Self-referral |
|---|---|---|
| Who starts it | The Board, after weighing disciplinary history, severity, whether practice can be limited and likelihood of success (OAR 855-011-0020) | The licensee, if the Board's rules allow self-referral |
| Condition | Written consent to share information among HPSP, the Board, monitors, employers and evaluators, consistent with ORS 179.505 and 42 CFR part 2 (OAR 855-011-0030) | Must attest that they are not, to their knowledge, under Board investigation. HPSP enrolls them on the date of that attestation |
| Evaluation | Independent clinical evaluator approved by the Board (OAR 855-011-0040) | HPSP must arrange an approved independent clinical evaluator and investigate whether impaired practice endangered the public |
| What the Board learns | HPSP sends weekly lists of Board-referred enrollees and completers | HPSP may not report enrollment or successful completion to the Board. Information goes to the Board only if the licensee is noncompliant |
The monitoring agreement (ORS 676.193)
Every enrolled licensee signs an agreement requiring them to:
- Consent to information exchange among the program, the board, the employer, evaluators and treatment providers.
- Comply continuously for at least two years to complete the program.
- Follow the recommended treatment plan.
- Submit to random drug and alcohol testing under federal testing regulations.
- Abstain from mind-altering, intoxicating or potentially addictive drugs, unless they are prescribed for a documented condition and approved by the program if the board has granted it that authority.
- Report any use of a prohibited substance within 24 hours.
- Report any misdemeanor or felony arrest or conviction within three business days.
- Report license applications in other states and changes in employment or practice setting.
- Accept limits on practice written into the agreement.
- Pay for evaluations, toxicology testing and treatment.
A workplace monitor is free of conflicts of interest. The monitor watches the licensee's safe practice, submits monthly safe-practice reports and receives noncompliance reports that may require the licensee to stop practicing.
Reporting noncompliance
HPSP must report substantial noncompliance to the licensee's board within one business day of learning of it (ORS 676.190(2)(e)). Substantial noncompliance includes:
- Criminal behavior.
- Conduct that harms the public or a patient, including sexual impropriety.
- Impairment at work.
- A positive toxicology result.
- Violating a practice restriction.
- Civil commitment for mental illness.
- Failing to participate after signing an agreement, or failing to enroll after referral.
The report includes a description of the noncompliance, the evaluator's diagnosis report, the monitoring agreement and the licensee's employment status.
Important
A self-referred pharmacist who complies quietly is never reported to the Board. A self-referred pharmacist who tests positive is reported within one business day, and the Board then decides on discipline.
Pharmacist duties around impairment
- A pharmacist who has reasonable cause to believe that another licensee is practicing while impaired, or is otherwise engaging in unprofessional conduct, must report to that licensee's board within 10 working days (ORS 676.150). Referring the colleague informally to HPSP does not satisfy that duty.
- Under ORS 676.192 (2025), a board may adopt a process letting a licensee who successfully completes the program petition to remove program-related information from board records.
- Participating boards may charge licensees eligible to enroll a fee of $25 per year to support the program (ORS 676.190(9)). HPSP must be audited every four years by an independent clinical evaluator.
Exam scenario
An Oregon pharmacist realizes they are misusing alcohol and is not under investigation. They self-refer to HPSP, attest that they are not under investigation, and complete an evaluation by an approved independent evaluator. They sign a two-year monitoring agreement with random testing and a workplace monitor. Eighteen months later the pharmacist completes treatment without a lapse. The Board is never told. If the pharmacist had been arrested for DUII during the program, they would have had to report the arrest to HPSP within three business days. The pharmacist would also have owed the Board their own arrest or conviction report within 10 days under OAR 855-104-0010.
A self-referred Oregon pharmacist enrolled in HPSP has a positive toxicology test for an unprescribed opioid. What must HPSP do?
Keep the result confidential because self-referred participants are never reported
Report only to the pharmacist's employer
Report the substantial noncompliance to the Board of Pharmacy within one business day
Wait until the end of the two-year agreement to report
Which statement about HPSP self-referral is correct?
HPSP notifies the Board when a self-referred pharmacist enrolls
The licensee must attest that, to their knowledge, they are not under investigation by their board
Self-referral ends the Board's authority to discipline for past conduct
Self-referred licensees are exempt from random testing
Which term is NOT a required element of an Oregon HPSP monitoring agreement under ORS 676.193?
Continuous compliance for at least two years
Reporting any arrest or conviction within three business days
Paying for evaluations, testing and treatment
Automatic expungement of the licensee's disciplinary record on enrollment
Sections you finish are checked off in the contents.