Alabama Administrative Code › Title 610 - ALABAMA BOARD OF NURSING › Chapter 610-X-14 - MEDICATION ASSISTANT, CERTIFIED (MAC) › Section 610-X-14-.29 - Reinstatement Of A Revoked Permit

Current through Register Vol. 42, No. 9, June 28, 2024
(1) Application for reinstatement of a
			 revoked permit may be made twelve months after the effective date of revocation
			 unless otherwise specified in Order or Agreement.
(2) Applications for reinstatement of a
			 revoked permit shall include:
(a) The
			 non-refundable application fee.
(b)
			 Detailed letter of explanation regarding the circumstances that resulted in the
			 revocation of the permit and actions the applicant has taken to address the
			 issue.
(c) Documented evidence of
			 any continuing education requirements for reinstatement of a lapsed
			 permit.
(d) Verification of the
			 status of all health-care related licenses, certifications, permits and
			 registrations from each jurisdiction/entity where a license, certification,
			 permit or registration has ever been issued and certified copies of any
			 disciplinary order(s) issued by any jurisdiction/entity where a license,
			 certification, permit or registration has ever been issued.
(e) Five (5) affidavits from persons who are
			 not related to the applicant and who have direct knowledge of the circumstances
			 surrounding the revocation of the permit and the actions the applicant has
			 taken to address the issue.
(f) If
			 the circumstances that resulted in the revocation of the permit involved
			 allegations of substance abuse, substance dependence, or drug diversion, the
			 applicant shall provide:
1. Documented
			 evidence of a comprehensive substance use disorder evaluation and fitness to
			 return to the practice without any Board monitoring, which evaluation shall be
			 conducted by a Board-recognized treatment provider whose program includes a
			 health care professionals tract and completed no more than twelve (12) months
			 prior to the date of the application.
2. Evidence of compliance with all treatment
			 provider recommendations.
3.
			 Complete results of drug screens obtained from participation in a
			 Board-recognized program of random drug testing for a minimum of twelve (12)
			 months immediately prior to the date of the application.
(g) If the circumstances that resulted in the
			 revocation of the permit involved allegations of physical or mental impairment,
			 the applicant shall provide:
1. Documented
			 evidence of current neuropsychological and physiological evaluations.
2. Compliance with all treatment provider
			 recommendations.
3. A statement
			 from the evaluators that the individual s fit to return to practice without any
			 Board monitoring.
(h)
			 Executed releases authorizing the sharing of information between and
			 communication with all necessary healthcare providers and Board
			 staff.
(i) Submission of results of
			 all required evaluations conducted by a Board acceptable licensed healthcare
			 provider in consultation with Board staff.
(j) If the applicant has any arrest(s) that
			 resulted in pending misdemeanor or felony charges, the applicant shall provide:
1. A detailed letter of explanation regarding
			 the circumstances surrounding the charges.
2. The nature of the charges.
3. The case number.
4. The jurisdiction in which the charges are
			 pending.
(k) If the
			 applicant has any misdemeanor or felony conviction(s) or has (regardless of
			 court disposition) entered a plea of guilt, nolo contendere, no contest, not
			 guilty by reason of insanity, or other similar plea, the applicant shall
			 provide:
1. Certified copies of court records
			 including the Case Action Summary showing the final disposition of the
			 charges.
2. Any written Plea
			 Agreement or Deferred Prosecution Agreement.
3. Documentation of compliance with
			 conditions imposed by the Court.
(l) If the applicant has been
			 administratively discharged from any branch of the armed services with any
			 characterization besides "Honorable" or has been court-martialed, the applicant
			 shall provide a detailed letter of explanation and official documentation of
			 discharge (typically, a D0214 Members 4 copy).
(m) For every period of employment since
			 revocation of the applicant's Alabama nursing license, the applicant shall
			 provide:
1. The name, address, and telephone
			 number of any employer.
2. The name
			 of any supervisor.
3. The dates of
			 employment.
4. Job title.
5. Description of job duties.
6. Reason for leaving said
			 employment.