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.

Kentucky Board of Nursing’s Compliance Branch consists of monitoring KARE participants and those with discipline on their license/credential to assure that these participants are safe to return to practice. The Branch also works with nurses who are seeking to reinstate their license following a period of disciplinary action (suspension, voluntary surrender, denied reinstatement).​

  • Substance Use Disorder (SUD) is a chronic, progressive illness characterized by the use of chemicals in spite of adverse consequences.
  • ​​SUD is one of the major factors threatening safe 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. 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.

  • 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 can help determine if there is an issue or concern.
  • 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 SUD 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 evaluator.
  • Participants must follow all recommendations of the Board-approved evaluator.
  • 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.
  • 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

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​​ is the licensure and disciplinary database for the repository of the data provided directly from state boards of nursing. It provides online verification of licensure.

Participation in KARE is not discipline unless through Agreed Order or Board Decision. ​

Yes – The KARE Program is a minimum of five years.​

Yes, if employed in a nursing position.​

Yes, participation in KARE requires drug/alcohol testing through the third party vendor designated by the Board.​

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

First, contact your Compliance Nurse Investigator. 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.​

Unless you entered KARE through Agreed Order or Board Decision then yes, upon successful completion.​

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

N​o - The Program is a minimum for five years.

While in monitoring you will have a Kentucky single state license in accordance with the Nurse Licensure Compact (NLC).​​​​

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

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, even if not an original drug of choice for you. As part of the KARE Program nurses are not allowed to use any mind or mood-altering substances.