Kentucky Alternative Recovery Effort (KARE)

​​​​​​​​​​​​KARE is a Program for Nurses

The Kentucky Alternative Recovery Effort (KARE) for Nurses Program was developed and is offered by the Kentucky Board of Nursing to identify nurses whose abilities to provide nursing care are compromised by a Substance Use Disorder (SUD), and to assist these nurses so that they can return to competent and safe practice.

  • SUD is a chronic, progressive illness characterized by the use of chemicals in spite of adverse consequences.
  • Substance Use Disorder is one of the major factors threatening safe nursing practice. 
  • This compulsive-use cycle may have periods where use is controlled, but is normally followed by at least one episode of out of control use causing adverse consequences in one's life.
  • Not recognizing or dealing with SUD will exacerbate the problem
  • Left untreated, SUD will not only risk your life, but the life and safety of patients

The foundation of the KARE for Nurses Program is that Substance Use Disorder is treatable and that the recovery and return of competent nursing practice is in the best interest of the nurse and public health.

  • Non-disciplinary, therapeutic monitoring program
  • A nurse may access the program by self-referral, Board referral, referral from another person or agency, such as an employer, co-worker or family member.

  • The first step is to admit there is a concern regarding alcohol or drug use.
  • Candidates for the KARE Program must be a Licensed Practical Nurse, Registered Nurse, or Advanced Practice Registered Nurse licensed in the Commonwealth of Kentucky, or an applicant for such licensure.
  • Candidates must Request KARE Program Participation in writing.
  • Candidates for the KARE Program must admit in writing to abusing, or being dependent upon, alcohol and/or drugs.  Guidance documents titled self-test-for-drug-addiction and self-test-for-alcoholism are available by searching the KBN document library using the words self and test.
  • Candidates who have previously been terminated from a similar program in this or any other state due to noncompliance may be ineligible for the KARE Program.
  • Candidates must obtain a Substance Use Disorder evaluation performed by a Board-approved evaluator, which conforms to Board guidelines.  A list-of-evaluators-by-city is available via the KBN document library by searching for the terms list of evaluators.
  • In order to be eligible for admission into, or continued participation in, the KARE Program, candidates and participants must follow all recommendations of the Board-approved evaluator;
  • In order to be eligible for admission into, or continued participation in, the KARE Program, candidates and participants must agree to the terms set forth in the KARE for Nurses Program agreement.
  • While the main purpose of the KARE Program is to facilitate participants' safe return to nursing practice, participants are not permitted to work in any capacity in a patient care setting, or one that requires nurse licensure, until approved to do so by a KARE Program case manager.

  • Successful completion of the KARE Program is conditioned upon compliance with all terms of the Program Agreement.

  • Failure to remain compliant, or resolve issues of non-compliance, will result in possible termination from the KARE for Nurses Program and suspension or denied reinstatement of licensure.
  • A suspension or denied reinstatement of licensure is disciplinary action that is reported to the National Council State Boards of Nursing disciplinary database NURSYS online validation, and other state, federal and certifying bodies, as applicable.
  • Board staff will make the determination regarding violations of the Program Agreement, subject to applicable laws and regulations

KARE Program Forms and Documents, including the KARE-Participant-Handbook are available by searching for the document title below in the KBN document library You can enter Compliance in the search and all of the forms will be available.​

Visit the KBN document library

  1. List of Evaluators by City
  2. ​self-test-for-drug-addiction
  3. self-test-for-alcoholism
  4. academic-performance-evaluation
  5. academic-verification-form
  6. case-manager-monitoring-schedule
  7. mental-health-substance-use-disorder-eval-components
  8. controlled-substance-log
  9. counselor-evaluation
  10. counselor-therapist-verification
  11. employer-verification
  12. KARE-participant-handbook
  13. monthly-meeting-documentation
  14. prescription-medication-report
  15. probation-parole-drug-court-report
  16. probation-parole-drug-court-verification
  17. relapse-prevention-plan
  18. treating-practitioner-verification
  19. work-performance-evaluation
  20. worksheet-for-aprn-in-monitoring
  21. worksheet-home-health-visits-aprn-in-monitoring






To obtain additional information and/or to seek admission to the KARE for Nurses Program, please contact the Compliance Program Coordinator


Frequently Asked Questions and Acronyms​

The Kentucky Alternative Recovery Effort for Nurses Program

National Council of State Boards of Nursing

The NURSYS licensure and disciplinary database is the repository of the data provided directly from state boards of nursing

Substance Use Disorder

Nursys.com provides online verification for endorsement to a nurse requesting to practice in another state and anyone who wants to verify a nurse license

Participation in KARE is not discipline and only the participation in the program is reported to the general public via license validation. Also, a KARE Program participant may lawfully answer no to a question about discipline.

Yes – The KARE Program is a minimum of five years, but in some instances this period has been extended by agreement.

Yes, and all other medical and mental health providers


Not if you reach treatment goals and have been released by your treatment provider

Yes, and it is located on the Affinity website once you begin monitoring

​This is considered a violation of your agreement

You will need to sign a cease practice agreement and notify your employer. You will also receive a Board order for a substance use disorder evaluation that will need to be completed and recommendations met

Yes, upon successful completion


No – KARE is considered an alternative to discipline program; therefore, your license is unencumbered.

It will be considered a “no show” and is a violation of your KARE Agreement and considered noncompliance with the terms of your monitoring.

No - The Program is a minimum for five (5) years.

You are permitted to travel and will need to contact your Case Manager prior to travel. In addition, you are required to locate collection sites in the area where you will be traveling within the United States.

The Board does not assist with job placement; however, if you need clarification on the terms of employment, please speak with your Case Manager.

Yes - The Program may determine that certain practice restrictions are necessary to ensure safe practice. For example, a nurse may not have access to controlled substances for a period of time. The Program will review and allow you to modify your Agreement as you continue to be successful in your recovery. The Program’s objective is to return all nurses to safe practice.

Alcohol is also considered a drug of choice and may also be substituted, even if not an original drug of choice for you.

Yes. Upon successful completion of the KARE Program, the Board regards records related to the relevant KARE Program admission and monitoring as confidential; however, any criminal court records must be judicially expunged pursuant to KRS 431.073-079.