Healing the Healers: Inside South Dakota’s Health Professionals Assistance Program

Our Guest: Amanda McKnelly, MS, LAC Midwest Health Management Services, LLC South Dakota Health Professionals Assistance Program

Today, we’re diving into an important topic that affects healthcare professionals across South Dakota. Our guest is Amanda McKnelly, the Program Director for South Dakota’s Health Professionals Assistance Program.

In this episode, we’ll explore the vital work Amanda and her team do to support healthcare professionals struggling with mental health issues and substance use disorders. We’ll discuss the program’s compassionate approach to intervention and treatment, the range of services they offer, and how they help professionals return to work safely.

Amanda will share insights on the program’s admission criteria, monitoring procedures, and some statistics on recovery success rates. We’ll also hear a powerful story of transformation from one of the program’s participants. Whether you’re a healthcare professional yourself or simply interested in how we can better support those who care for us, this conversation offers valuable perspectives on addressing mental health and substance use issues in the medical community.

Transcript:


Terri
Welcome back, everybody, to Diversion Insights. My guest today is Amanda McKnelly, the program director for South Dakota’s Health Professionals Assistance Program. Many of you know I’m trying to make my way through all the states. And so here we are with South Dakota. Welcome, Amanda. 


Amanda
Thank you. 


Terri
Tell me a little bit about how you got into this position. What was the history that got you where you are today with the South Dakota’s program? 


Amanda
Sure. So the South Dakota program was created under statute in 1996, and I’ve been a part of it kind off and on for several years, but then really came on about 12 years ago, Maria Piagetino, who is also here, she has been around since the inception of the program. And so she reached out and said, hey, let’s do this together. The program used to be under a hospital in South Dakota. So either one of the major hospitals was housing the program. And so she said, you know, it’s a barrier. So someone who works at one of the big hospitals doesn’t want to walk into their place of employment and seek help or go to their competitor and say, oh, why is this physician or why is this nurse coming here? 


Amanda
So kind of it was all the licensing board said, hey, let’s get this outside of one of the main hospitals to hold the contract. So Maria and I created this business, and we bid the contract, and so that’s how we got the Health Professionals Assistance Program underneath our business of Midwest Health. So been doing this for, like I said, about 12, 13 years now. Again, so great. 


Terri
That sounds like a great move to do that. All those reasons you mentioned to move it out of that hospital make perfect sense. Yeah, that’s great. And I also want to say, you come from a beautiful state. I am next door to you now in Wyoming. And we took a trip up Cheyenne and then came through the Black Hills, and, man, the minute we hit the Black Hills. Wow, that was gorgeous. 


Amanda
It’s so relaxing and peaceful, for sure. Out there. Yeah. 


Terri
Yeah, definitely. I was surprised. I didn’t know what to expect, but it was. It was beautiful. So I read the philosophy of your program, and among other things, it states, we believe these illnesses, namely mental health and substance use disorder, can be successfully managed and treated. Compassionate intervention can help save an individual’s career and possibly his or her life. These are individuals who have dedicated their lives to helping others and are now in need of care themselves, which I thought was really neat. It kind of that. That really summarizes things. What licensed professionals does your program service? 


Amanda
Yeah. So a title 36 in South Dakota, anybody underneath that title is allowed or able to access the health professionals program. So that’s, you know, anybody underneath. Basically it’s the helping as what I call a title in the South Dakota. But the main ones right now that we have Midwest Health has agreements for is the Board of Nursing, the Board of Dentistry, the Board of Pharmacy. We have the addiction professionals, we have the mental health professionals, and we have the psychology board, are all ones that we have actual written agreements for. However, again, anybody can reach out and say, hey, I have this individual. I don’t have agreement, but can they access the program? Absolutely. And then we can work on getting their board because they’re all eligible for it. So. 


Amanda
And then we also have the physician wellbeing program that they all are able to access us. 


Terri
Okay. When you say physician wellbeing, is that different than the physician’s licensing board or. Yep. 


Amanda
So the physician’s licensing board used to have an agreement with Midwest Health. And then they do their. They do strictly their own monitoring underneath their board. And then the medical association was able to get a bill passed to be able to do a wellbeing program. So any physician that’s licensed in the state of South Dakota can reach out and they can get individual counseling. They can seek help as long as there’s no impairment. They can seek help through us, through that. So the medical association did great work there. And the physicians are able to access that. We do the residents. And they just got it passed also for medical students too. So. 


Terri
Okay, so would they typically do that on top of what they’re doing with their licensing board or kind of in lieu of. If they’ve voluntarily just kind of recognize that they need. 


Amanda
Yeah, yeah. So in lieu of like we would not. The licensing board does their own monitoring. So these would be individuals that potentially don’t need monitoring, are more of a well being. We do have the capability to do the monitoring as long as, again, there’s been no impairment, if there’s any impairment. Or they would have to be referred to the licensing board to do that monitoring, as they’re the ones that do it for their board. 


Terri
Okay, so that kind of takes us to. Is this a alternate program where they can be anonymous and same for all of the disciplines. So how do people enroll and then the different ways that they enroll, what does that look like for notifying the licensing board? 


Amanda
Yeah. So anybody can self enroll. Anybody can be referred by their employer, their therapist, a friend, attorney. They can all voluntarily enroll in our program. A majority of our board of nursing participants. I Would say it’s about 50 right now where half are volunteering, half have been board mandated. So their licensing board has mandated them to participate. So we can seek both. If they’re here voluntarily, that’s great. I mean we encourage that to have people seek help before their licensing board gets invol. So we can do both aspects. As far as the board of medicine though, if they were to be mandated, they’re mandated to their own program, this would be a voluntary track. 


Terri
Got it. Okay. So 50% of nurses are voluntary. I think that’s a high percentage. I feel like that’s higher than other states have indicated, which I think is fantastic. You’re right. You’d rather get them to volunteer. So if they do come in voluntarily, are you required to notify the license? 


Amanda
Yeah. So under nurse compact law, we are just required to state Jane Doe is a voluntary participant because then their license has to be switched over from compact to a single state license. They don’t ask any questions, we don’t have to give any reports, nothing like that. There’s just one person that we work with there that we give the name to. And then when they successfully complete, we say Jane Doe has successfully completed. And then as long as everything stayed great on their license, they switch them back over to the compact. So that’s a compact law that I think maybe, I’m not quite sure, maybe in 2019 ish timeframe I think, or maybe even before that was what had, what has to happen. 


Amanda
So they’re voluntary, their name gets switched, but the board doesn’t know there’s one person there that we contact that switches them back and forth. So. 


Terri
Interesting. So let’s talk about that for a little bit. So the compact law allows them to practice in other states, right? 


Amanda
Correct. 


Terri
Okay, so taking that away then means they are only, excuse me, licensed in South Dakota at the moment, which theoretically keeps them from going next door to the next state or moving on. Right. Okay, so then does she notify other state? Like how does that communication get put out there for all of the other states? 


Amanda
Yeah. So like if Jane Doe was going to try to go to Iowa or Nebraska, I’ll just say a neighboring state because they fall underneath compact, they’re applying for a job. They would see that they’re a single state license. So then they would question maybe the nurse, like why do you not have compact? Or that would probably question there when they’re a voluntary participant because otherwise they would have notice or have no way of knowing that they’re in the alternative discipline program. Right. So if they’re a mandated participant, it goes out on nurses. And so then if I’m applying down in Iowa or Nebraska, they’ll be able to see my board order through nurses that, you know, she’s been mandated to South Dakota, and here’s why. So when they’re voluntary, they don’t see that because there’s no board order. 


Amanda
So they would just question the nurse probably if the nurse wasn’t open to them when they go to apply. Like, hey, I don’t have an Iowa license. I need to apply for the Iowa license. I’m in the South Dakota program. They’ve given me permission. I’m here voluntarily. So that would be kind of the route that we would help them if we felt that they were safe to be able to be in both states, too. 


Terri
Okay. And you mentioned nurses. So is that where this contact at the licensing board would just update that and they would look there and see. Because I’ve seen that where it’s non compact versus compact, and I’ve never. I thought, well, maybe that state doesn’t do compact. Is that where it’s typically. 


Amanda
Yep, yep. So it would just be updated and they would be switched over. So there. It would say there’s no discipline and that it’s just a single state as they’re voluntary. Yep. And then they also do it on, like, their board site. You know, the board of nursing sites. 


Terri
Right. Okay. All right. So just for the listeners that aren’t familiar with nurses, it’s a great site and you are sys. And you can look it up based on name and state and see if their license is in good standing. I will tell you, though, I have recently run into three cases where the nurses and on nurses. Oh, yeah, I know. Weird. So the first one I kind of went into like a. Whoa. You know, we’ve got a somebody who’s forging their, you know, license, but went to the. Directly to the board of nursing that said, look on nurses. Like, well, okay, I tried that. Ended up getting a hold of somebody and they were able to confirm verbally that they were licensed. Never gave me a reason as to why it wasn’t on there. 


Terri
But then just two other nurses in a different state. It just happened. And I told the facilities, you might want to have your HR check, and they came back with they are licensed. So I’m not quite sure how that happens. So don’t freak out because it has happened. And I freaked out the first time. 


Amanda
But it’s a little odd Interesting. I wonder if it was that whoever is supposed to be entering is not entering it properly or something. I don’t know. 


Terri
I don’t know. I mean, yeah, if it’s a person doing it, then I guess it’s just a person who made an erro and that happens. But yes, it was a little. I assumed it was maybe kind of an automatic feed going in, but maybe it’s manual. 


Amanda
Maybe. 


Terri
But it’s a great. It’s a great resource to look that up. Okay. So voluntary, you just tell the one person, and so then they change the compact license. And I would assume, you said it was a law that was put into place or a regulatory thing, so every state must have to do the same thing. I’m going to guess right. 


Amanda
Yeah. They should all have to follow it. Yep. 


Terri
Okay. If they’re. If they’re a compact state. Okay. Well, that’s. That’s good information to know. I guess that means if I ever do work in South Dakota and I see somebody that doesn’t have a compact because that’s automatic or. No, do you have to apply for compact? 


Amanda
So you apply for it, and I think most people apply for it because. Why not? Yeah, I think most people who live in a compact state apply for the compact, so that way they’re not having to pay for all these states if they were to go somewhere else. Sure. 


Terri
Yeah. Okay. So that could be a little. Maybe I better check into why they’re not compact if it’s a compact state. 


Amanda
Okay. 


Terri
Interesting. All right. So what services does your program provide? Walk me through. If somebody comes to you, either voluntarily or through their, you know, however they get to you, what does that look like once they come to you? 


Amanda
Sure. Yeah. So everybody, they will have an initial risk assessment is what we call it. So they meet with one of us case managers, and if they’ve just come from treatment or they’re coming from treatment or they just had an evaluation done, we would piggyback off of that evaluation. But everybody’s licensed here. So we go through and do a full evaluation with them and kind of determine if, hey, do they need to go to treatment? Do they need to see a psychiatrist? What needs to be done right now? So everybody starts with that. And then we gather all their information and their records and we take it to what’s called our evaluation committee. Our evaluation committee is made up of a physician, nurses, pharmacists. Let me think. 


Amanda
And then all of us case managers, there’s a therapist on there, and the committee outside of us case managers have all been involved in the program, Some have been involved for 10 years, and they help come up with what the recommendations would be. So they have guidelines that they follow from the board. They’ve all been appointed to the. To that committee from the board, and they serve terms, and most of them have continued to serve their terms and they come up with the recommendations. So we call it a participation agreement. And the participation agreement will state whether they have to do random toxicology, go to treatment, go to intensive outpatient, meet with a psychiatrist, meet with a family practice doctor, Whatever those recommendations are, we kind of come up with those and then we meet with them again and go over that with them. 


Amanda
So that’s kind of the initial steps and starts of how we tailor it to each individual. You know, years ago, it used to be everybody was going to be in the program for five years. And here are all the things that you have to do. We don’t do that. It’s truly case by case, scenario by scenario. So we want to do what’s best for the participant and, you know, get them to the most appropriate places because one size doesn’t fit all. So we’ve really changed our philosophy a lot on that over the last several years. So. 


Terri
Yeah, that makes sense. How? I’m not a licensed therapist and so I don’t sit in on those conversations. But how do you determine? I mean, I would imagine that if somebody comes to you and it’s not voluntary, that they may still try to deny and downplay what they have going on. So how do you get to the bottom of that? Is that, I mean, just the expertise of the person doing it, or do you have a certain process by which you get to the truth? How does that work? 


Amanda
Yeah, so kind of a little bit of all of that. I mean, so a little bit is just kind of knowing and knowing the diseases. That is very helpful. And I think if someone’s coming voluntarily, for the most part, they’re pretty open and honest. You can tell maybe there’s a little bit of dishonesty, but that’s a little bit more helpful. But if they’re coming mandated, you know, it’s nice that we get records of the complaint to know why they are board mandated. So we have a little bit of that background and then, you know, it’s weird to say, but it eventually shakes out. Sometimes it may take a year for them to really trust you and really know that we are here to help and advocate for them and we want to see them get well. 


Amanda
So sometimes it could take up to a year for some of them to kind of really let their guard down and the full truth comes out. But I hate to say it, but like that it just sometimes just takes for them to have that first positive drug screen to say, okay, all right, I’m finally going to be honest. Or like a complaint from the work, like they’re just being really late, they’re not coming, and kind of to finally say, oh, okay, I can’t get out of bed. I’m feeling so depressed. You know, sometimes it just is takes that little extra thing to happen for them to finally say, okay, fine, I, I will be fully honest. So, yes, it takes a little bit of all of that together. 


Terri
Okay. So if they’re mandated and they come in for that assessment and they’re a great liar, you don’t just say, they don’t seem to need it. And so why did you send them to us? Okay, you can do. 


Amanda
Yeah, we ask them to sign a release of information when they come to us. And so then we get it, we get a release to the board. And so then we ask, can we get the complaint information? And so then that sometimes will say is like, hey, I know you’re saying this, but on the complaint it’s saying this, tell me about that. So then we can kind of go back to that a little bit and they’ll. Then they can justify or try to say, oh, yeah, I forgot to tell you that, or things like that. 


Terri
So yeah, okay, that makes sense. All right. Any exclusion criteria, any time, they would be denied the ability to participate in your program. 


Amanda
Yeah. So if they have diverted substances and for not their personal use, that is an exclusion that the board has out there for sure. I will say sometimes we have asked people that have come through the program and have not successfully completed to do certain things before reapplying. Some people would reapply and if they still haven’t met those things, they would be asked to please go back and do that. Whether that’s treatment or whether that’s evaluations or whatever it is, those would be the number one reasons I would say why are why they would be denied participation. Okay. 


Terri
Yeah, that makes sense. And in terms of treatment, do you, can they go anywhere? Do you have a list of ones that you refer them to? How does that work? 


Amanda
Yeah, so Maria and I try to travel around the state and reach out to providers and get what we call approved providers. And then we give those to the boards and the boards agree or don’t agree with them. And we. So we have Approved lists. But however, if somebody has an insurance and their insurance doesn’t approve one of those people on our list, we then work and try to say, okay, let’s see who’s on your list. Let’s see who has the correct credentials and is willing to give us documentation back. Because that’s part of it is, you know, somebody can go see a therapist or go to treatment or see a physician, but then they’ll never release records to us or they’ll never get it back to us. 


Amanda
And so then we can’t help that person and can’t get them going in the right directions when we never get any documentation back. So. 


Terri
And I would kind of assume that not all treatment programs are equal. I mean, maybe some are not as successful. Right. So you want to be sure you set them up for success. 


Amanda
Yep. 


Terri
Yeah. Okay. 


Amanda
And a health care professional is different than somebody who is a laborer and who is working construction and who is, you know, we. They are truly everybody’s stressors are completely different. And so we like to have places that specialize with healthcare professionals. 


Terri
Right. Is there any cost associated with your portion of the program? 


Amanda
Yeah. So each board has it set up a little differently right now in our state. So it used to be no matter any of the major licensing boards. So the physician, dentistry, nursing and pharmacy, 100% of their participation was paid by their licensing board. That has changed a little now over the last several years. The board of pharmacy and dentistry still pay 100% of their participation fees for their participant. All the other boards have it set up differently to where they cost share or the participant is responsible for the fee. So some are paying a quarterly fee of like $250. It’s on average, it’s $3,000 a year to participate in the program. That has been since. For the last 12 years. So that price has never changed. 


Terri
The only place where the inflation hasn’t hit. 


Amanda
Right, right. So the participants. So that’s been a little bit of a challenge. And I think our numbers have decreased a little bit because I think as a nurse, if you’re terminated and you have no job and you know you need to go get help, but you can’t afford it, you just say, see you later, I can’t do it, and then eventually come back. So that, I think, has been one hard thing a little bit for our nurses, for sure. But so each board has it set up a little bit differently. It’d be great if everybody, you know, was all on the same page and did it all the same Way where they pay 50 or, you know, it was 100% covered by their licensure fees. 


Terri
So, yeah, that is hard. Obviously, your program needs to be paid for, but at the same time, it’s not the right time, too, because I imagine on top of that, I’m going to guess, are drug screens. I mean, do you include that in the cost or that’s extra. 


Amanda
Yeah, yeah. So drug screens are not included in that. So they have to pay for their drug screens and then whatever therapy they go do, hopefully they can use health insurance for that. But on average, their screens are costing 40 to $70 a piece to do those too. 


Terri
So. Yeah, consequences. But at the same time, you want to do what you can to get them in there and then help them be successful. Okay. All right. Are you involved with continuing to monitor for return to work? And if you are, what kind of parameters do you have set up to ensure safety of the patients and the healthcare professional that’s going back to work? 


Amanda
Yeah. So obviously our ultimate goal is to get them back to practice. And so I would say, you know, it’s probably 50 that are still practicing when they come to us, I would still say so we get a release of information for their direct supervisor. And so that direct supervisor then is aware that they’re in the program. We then get either monthly or quarterly reports from them, have communication with that direct supervisor that if they ever have any concerns, you know, don’t wait the three months or the month, you know, reach out. So there’s communication back and forth there. They’re not practicing again. They still, when they go to apply for a job, they have to be in communication with us. They have to share with that place of employment, again, get a release of information, share with them that they’re in the program. 


Amanda
We have a matrix that we use that when we’re going over with somebody, are they ready to return to practice? We get feedback from their therapist, their physician. Have all their drug screens been. Been negative? How is there a stability in their mental health with their depression and anxiety? So we kind of put all these things together in a matrix, and that’s what we kind of go by when we’re looking at safe return to practice. 


Terri
Okay, now, is all of that you just said true for both the voluntary and the mandated? Yep. Okay. 


Amanda
Yep. 


Terri
All right. So if they come to you voluntarily and they’re still working, that’s one of the agreements with them that you make, is you need to go back to your workplace and tell them that you have voluntarily Placed yourself in the monitoring program. 


Amanda
Yep. Okay. Yeah. 


Terri
Okay. I don’t know that everybody does that. I mean, I think it’s good. And obviously it depends on why they’re there in the first place, but. So that would probably indicate. Well, I don’t know. I was gonna say that they hadn’t diverted. They just have an issue that they recognize they need help with, but. But maybe they’ve already diverted and they realize they need help. 


Amanda
It is interesting because I think most people think that HPAP is only for substances. And so I think it opens up a little bit like, well, we are here for mental health too. We monitor both. So I think in our case, management is for both. And so I think for people to realize, like, okay, it could be that they lost a spouse, a family member, a significant other, and they just they are struggling mental health wise so bad that. So I think that it’s kind of nice that it opens up to people to realize, like, okay, not everybody’s here for substances. 


Terri
Right. Or alcoholism too, which, you know, they’re not getting from work, they’re just struggling with. Do you have an idea of what percentage of your people are. That would be an interesting statistic. Which ones are controlled substance. You know, substance use disorder, not alcohol, but controlled substances. So access at work. And then another statistic that would be interesting. And I’m going to guess you don’t have these, so I don’t mean to put you on the spot, but. And then those that voluntarily come into the program, how many are mental health versus substance use disorder? I wonder if the substance use disorder people tend to deny, deny, and they come in mandated, whereas the others are the ones that are coming involuntarily. 


Amanda
I would say yes. Like if. Just trying to think of my numbers right now off the top of my head. And I would say most of the mandated are the controlled substances. Okay. Obviously, I would say we don’t truly have like a true alcoholic anymore or true opioid use disorder anymore. We kind of have. It’s. Most of them are dual diagnosis, you know, But I would say, yeah, I think you’re right on there. I think most of the mandated are more of the substances and even not alcohol. I think it’s the opioids. 


Terri
Right? Yeah. Because those are the people that have gotten where they’ve gotten. Let it go a little too long. It would have been nice if they had voluntarily come in before that when they started heading in that direction and now it’s a double down. I mean, they just can’t yeah. Admit to that. Okay. How. I’m sure it’s different for everybody and different depending on what you’re coming in for. But how long are your monitoring programs and contracts with the participants? Typically four? 


Amanda
Yeah, I would say on average now where they’re probably about three years. I would say, you know, 10 years ago it was easily. Most people, if they had a dependence or a severe diagnosis, they would be a five year agreement. You know, we’ve seen more and more trending to be that three to five year. But most are the three year agreement. We do some rule out risk. Our rule out risk is six months to a year. So that might be a student or somebody that maybe has had some past legal or hey, they’re struggling a little bit. Not sure if they truly need full monitoring. We may just do a little rule out to make sure that there really isn’t more going on than what they are presenting with. So I’d say on average about three years is what we’ve been doing for monitoring. 


Terri
Okay. And back to the statistics. Do you have an idea of how many choose to go back to work? And again, maybe it’s not broken down into those with a substance use disorder, specifically how many choose to go back to work versus those that don’t. It’s just like I’m not going to put myself back in that environment either because they’re afraid of the whole recovery process and not being able to maintain that, or they just realize it’s maybe not healthy for them for other reasons. 


Amanda
I would say probably 98% of our people go back to practice in some capacity. I would say we’ve had a few where they will come to us, they’ll do some case management and monitoring for a while and then they’ll say, you know what, I just think I’m ready to be done, I’m doing well, but I don’t see myself going back. But those that do go back, not all of them go back into like bedside nursing. They may go to clinic setting or they may go to more of like a case management role. We do have some that will go back that have never had access to controlled substances again and they don’t want to. And so if we successfully complete them from the program, we notify the board, you know, if they’re mandated and say they were here for diversion. They’ve never had access. 


Amanda
So we’ve never been able to monitor them with access. Just so that way that’s kind of noted on their license to or however they keep track of the board. But I would say most all of ours, yeah, they do. They do go back to practice in some capacity. 


Terri
Okay. Any statistics on long term recovery success? I imagine that’s a little bit hard to come by. 


Amanda
Yeah, yeah, it is. You know, we tried to do some surveys. You know, we do have some individuals that stay with us that do mentoring. So we call it graduate weighted recovery or senior monitoring, where some will stay on with us for a while. And then they say, hey, we want to be a mentor for individuals that are in the program. So we do have. We do have quite a few that do that will stay on that way. But we try to. We tried to do this to figure out, like, how far out somebody has been able to come back and tell us they’re still doing well, but after six months to a year, they’re kind of like, we’re done. We don’t want to talk to you anymore. 


Terri
I don’t want to be reminded about this. 


Amanda
I’m moving on. 


Terri
Yeah, yeah, no, that makes sense. Yeah. Well, I always like to hear success stories because I think it is difficult for a lot of people to wrap their head around giving people an opportunity to go through recovery. And I’m specifically talking about someone with a substance use disorder, and that has brought that into the workplace. It’s hard sometimes to see, yeah, you know what, let’s try to give them an opportunity to go through recovery and be successful and then potentially come back to work. Right. Do you have any stories that stand out in your mind of people that, had it not been for your program, the outcome may have been completely different? 


Amanda
Yeah, absolutely. One sticks in my head quite a bit of someone who lost their nursing license, was completely at her rock bottom of not having what she wanted in her life, you know, completely her bottom. Came back voluntarily, enrolled with us. We helped support her, seek her license back, went back to the board of nursing, granted her her license back. She was able to maintain amazing sobriety, amazing mental health all through her programming. While she was with us, she started classes for her nurse practitioner and both as a therapist. And so she was able to get a management role at her. At her job, was able to graduate with her nurse practitioner license, graduate with her therapist license. She is an amazing mentor for our participants, still stays in contact with us. And I mean, she is. 


Amanda
She tells us how grateful she is to be able to have had that second chance. She does such a great job with our participants to be able to say, I’ve been there. I know what you’re feeling. And I know, like, how angry you are about having to either be in this program or how angry you are that you allowed yourself to get so far out of control. And I think it’s just those are the individuals that come to us who are at their bottom and then go and get management positions and can stay like they deserve a second chance and sometimes maybe a third or fourth, you know, and they then can get there and be so successful, and it’s. That’s why we do what we do. 


Terri
An example of living out your philosophy that compassionate intervention can help save an individual’s career and possibly their life, right? 


Amanda
Yeah, absolutely. 


Terri
Don’t know what that alternative may have been for her if she hadn’t had that. 


Amanda
Right. 


Terri
Yeah. Okay. Before I let you go, is there anything that you would like to say directly to any South Dakota licensed healthcare professionals that might be listening to this? 


Amanda
Yeah, I just say reach out, ask questions. If you at all feel like you maybe are struggling with your mental health a little bit more than you should be or an addiction, and not quite sure we’re not scary people. We want to help you. We want to see you do well, and I think this is our passion, and we know that we can help you get back to your full capacity. We want to see you working, and so just call, ask questions, email, whatever it is, we want to help you. And early intervention is the best. Don’t let it get out of control to where you are now in trouble, legally or with your board. So we want to help. 


Terri
So I couldn’t have said it any better, Amanda. So with that, we will wrap this up, and I want to thank you very much for participating in this to get the information out there. I think that for those in my position, when, you know, we’re monitoring for somebody that is potentially diverting and, you know, that’s the only piece that I look at, not the underlying mental health and all the other issues, but we. I see often that people don’t know what to say to the licensed healthcare professional in that state in terms of where to go next. Like, this is what you need to do next. 


Terri
And so that’s why I want to, you know, hear from every state, because many states have fantastic programs, and I think our professionals need to know that and increase the chance that they will come voluntarily as well, because it’s there for them. 


Amanda
Yeah. Yeah, absolutely. 


Terri
All right, fantastic. Thank you very much, Amanda, for your time. I hope you have a great rest of your week. 


Amanda
Yeah, thank you. And thanks for having me. 


Terri
Absolutely. 

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