Compliance Monitoring Forms & Probation Information

 

Compliance Monitoring Forms

   Re-entry to Nursing Practice
   Quarterly Substance Use Disorder/Mental Health Continuing Treatment Form
   Contact and Change of Information Form
   Employment Status Report
   Prescription Identification Form
   Sobriety Notebook
   Support Group Attendance Form

Probation Information

   ATI Information
   Chemical Dependency Evaluator List

Third Party Administrator (TPA) Information

As part of your monitoring program with the Missouri State Board of Nursing (Board) you are required to contract with the Board’s third party administrator (TPA).

You have two companies you may choose from. It is important that you make an informed decision on the testing company that you choose. To discuss the check in, testing, and payment policies, contact the companies directly.

Frequency of testing and the testing panel will not differ. The cost of urine drug testing averages about $55 - $95 per screen. The cost of blood, nail and hair drug testing averages between $130 - $490. Costs will vary based on testing requirements and are the participant's responsibility. All samples, regardless of the company, must be directly observed upon collection. The time frame for checking in to determine if testing is required will not differ, it is defined in your legal document as seven (7) days a week between 5:00 a.m. central standard time and 4:00 p.m. central standard time.

Once you have chosen the TPA and contracted with them, the Board expects you to remain with that company. If you should decide to change TPAs for any reason, there must not be a gap in checking in. Approved third-party administrators are:

Affinity Care (Spectrum)
1-877-267-4304
Affinity Packet
If you have chosen Affinity, please email nursingcompliance@pr.mo.gov.
National Toxicology Specialists
615-353-1888
NTS Packet
If you have chosen NTS, please see NTS instructions.


Compliance Contact

573-751-6541 Telephone
nursingcompliance@pr.mo.gov

News

NEW: COVID-19 Information for Monitored Licensees
3/21/2020
If you have been directed to self-quarantine due to diagnosis of or exposure to COVID-19, please DO NOT go to a drug screening collection site, meetings or other activities that could expose others. Submit your quarantine order documentation to nursingcompliance@pr.mo.gov. We will suspend daily check-ins and drug testing during this period.

In the event there is a state or regional quarantine/shelter-in-place order, please DO NOT go to a drug screening collection site. The sites likely will be closed. Email nursingcompliance@pr.mo.gov of this information so we can suspend drug testing during that time. If you are required to submit to random drug screen, you are still required to check in daily with the third-party administrator (TPA). We will monitor the situation and restart drug testing when it is safe to do so. The only way you will know that drug testing has been resumed is by continuing with your daily check-ins.

If meetings or other activities are canceled please keep any records or documentation and report that by email to nursingcompliance@pr.mo.gov.