All Staff
How many drug screens are needed per month for patients?
STATE-1 weekly for first 90 days, then at least once per month randomly.
ACADIA- weekly for first 90 days, then three times monthly for phase 0-5 and 2 per month for phase 6.
What State Regulations do we follow?
DSH 75.59 and DSH 75.60
What do we do if a patient refuses to complete a ROI for collaboration of care?
Complete a letter stating that patient refuses to collaborate care, have pt sign or put in refuses to sign, and upload into the patient's chart.
Within intake and annual paperwork, what is form A12?
ROI or Release of Information.
How often do you update your treatment plan and SNAP?
Every 90 days
Where can Policies be found?
Policy Stat
Per State Regs, when a pt tests positive for an illicit substance OR miss a callback, whom are a phase 5 or 6, what phase do they go to?
These patients should be staffed for clinical probation and go the phase 4 for 90 days.
How often do callbacks occur?
These occur randomly every 90 days.
How many Stages of Change are there?
1. Precontemplation
2. Contemplation
3. Preparation
4. Action
5. Maintenance
6. Relapse
What do treatment plans consist of and what is needed within the treatment plan summary?
Tx plans must consist of Dimensions 1, 4, and 5, and any other ASAM Dimensions that patients need.
Plan Summary must include the patient's current phase and medication and mgs, and a statement stating that the patient agrees to take their prescribed medication daily, meet with PC for 1-2 hours monthly, attend all group sessions as scheduled, and provide 2-3 random UDS per month.
If someone wants to change counselors, how can we direct them?
Have patients fill out a Counselor Change Request form at the front desk
What paperwork is required every 90 days within a patient's chart?
1. Tx Plan
2. Staffing Review Report
3.Ongoing ASAM LOC
4. Ongoing Continuing Care Plan (every 90 days for 1st year then annually)
5. SNAPs
6. PDMP
What policy practices do you follow with pregnant patients?
Policy 5.15: ROI for OBGYN and one for delivery hospital, Pregnancy Education packet and assessment, coordination of care letter to OBGYN to verify prenatal care, counseling/medical Pregnancy note (1 per trimester), and one postpartum counselor/medical note after delivery.
What must be completed and in the patient's chart before they dose on their intake day?
1. A01 Consent to Treat and Financial Responsibility
2. Signed PDMP
3. Admission Clearance form
4. A13 a-e Informed Consent to Treat with (Methadone, Suboxone, Vivitrol)
5. MD must sign Physical Exam and Orders
What does SNAP stand for?
S-strengths
N-needs
A-abilities
P-preferences
What situations require an incident report and where can they be found?
Dosing errors, medical emergencies, slip/fall injuries, major behavioral issues, any time police/fire/rescue is called, etc.
In the office of any CD, CS, or NS.
How often do patients phase while prescribed Methadone or Suboxone?
Every 90 days for Methadone and every 30 days for Suboxone.
How often does a pregnant pts need a P/T?
Every trimester.
Who meets criteria for MAT treatment?
Anyone that has used opiates within a year or longer, anyone that is pregnant, anyone that has been involved in MAT tx within the past 2 years, and someone who was released from a chronic care setting within the past 6 months.
What are the ASAM's 6 Dimensions?
1. Acute Intoxication and/or Withdrawal Potential
2. Biomedical Conditions and Complications
3. Emotional, Behavioral, or Cognitive Conditions and Complications
4. Readiness to Change
5.Relapse, Continued Use, or Continued Problem Potential, Discharge Planning
6. Recovery/Living Environment
What is a QRR Peer Review?
An audit tool to assist in helping identify required items needed within a patient's chart of another counselor.
What does the 8-point criteria consist of per State regs?
1. No illicit substance use
2. Regular attendance
3. No serious behavior issues in clinic
4. No criminal activity
5. Pt has stable home environment
6. Length of time in treatment
7. Pt has an appropriate lock box and can be stored safely
8. The benefits of take-home bottles outweigh the risk of diversion
Who would qualify for a split dose and why would it be needed?
Dividing the dose of methadone or buprenorphine in two daily doses (also known as “split dosing”) taken 10-12 hours apart help manage the impact of metabolic changes on serum levels, particularly for women in the third trimester of pregnancy or someone who metabolizes quickly.
Need 2 peak and troughs, state exception, and UDS results.
If someone does not have a mental health provider, that is in need of one, how would we proceed?
Refer them to complete a full MH assessment with a counselor or MH provider (Lynda) who has a MH license.
What is included in a COSAT treatment plan?
Dimensions 1, 4, and 5, problem, goal, method, and intervention. Whatever substance pt's uses other than opiates are required as a problem in the tx plan.
Plan Summary needs to be the same as MAT but without medication and mgs. Phase should be COSAT.