Intake Policies

1. Criteria for admission –a. Patient must be at least 18 years of age as proven by driver’s license or other photo identification.

b. Patient must demonstrate ability to pay for treatment or be a member of a group with which the program is a participating provider

c. For METHADONE MAINTENANCE, must have demonstrable:

1. Tolerance to opioids
2. History of compulsive daily self-administration of opioids
3. Current dependence on opioid of at least year’s standing
4. Meet ASAM Criteria for residential level (short term) of care

d. Exceptions for METHADONE MAINTENANCE:

1. Persons recently released from a penal institution
2. Persons recently discharged from a chronic care facility
3. Pregnant women of any age
4. Persons previously on MMTP

e. Detox Only

1. Demonstrable tolerance and dependence
2. Current signs of withdrawal including three or more of the following:
a) Dysphoric mood
b) Nausea or vomiting
c) Muscle aches
d) Lacrimation or rhinorrhea
e) Papillary dilation, piloerection or sweating
f) Diarrhea
g) Yawning
h) Fever
i) Insomnia

Residential and Detox

f. Patient must be willing to sign all required Federal and State forms authorizing care.

g. Patient must be free from symptoms of major psychiatric disorders that would make it impossible to render “informed consent” to care.

h. Re-admission policy

Any patient previously discharged may seek readmission to the Clinic. It is the policy of CDT to evaluate any former patient based on current status rather than on past history. Patients who were administratively discharged may be required to complete a behavioral contract before admission or may be asked to meet with the full clinical staff to discuss past problems.
Discharged patients with a past balance due the company must satisfy the obligation before being considered for readmission.

i. Exclusion policy

The following types of individuals are excluded from admission to the
clinic:

• Persons incapable of providing informed consent
• Pregnant females seeking detoxification while pregnant
• Persons who are actively experiencing psychosis
• Patients who do not meet admission criteria
• Persons who present a clear and present danger to themselves or others
• Persons with a past balance owed the clinic

Histories – CDT holds the philosophy that a full and complete patient history is the basis for a sound understanding of the antecedent conditions of the patient’s need for treatment, and the subsequent formation of an effective treatment plan. The intake process will include the gathering of data concerning the patient’s medical history, drug and alcohol use/abuse history and his or her personal/psycho social history.

CDT intends for the treatment planning process to begin with the first contact with the prospective patient, and to be activated at admission. The Individual Treatment Plan begins at this point in patient care, and a “preliminary” plan is initiated. The treatment plan is the document that actually directs treatment.

The treatment plan begins as the CDT staff continues to evaluate the patient. All CDT treatment plans begin with an initial plan dedicated to treatment issues that are preliminary and common to newly admitted individuals. This page of the plan should be completed and provided to each new patient during the admission process.

a. On the day of his or her admission, each new patient will meet with a staff counselor assigned to that day’s admissions process. The counselor will coordinate with administrative and medical staff to begin the orientation process, assisting in the completion of program intake and admission forms, identifying the need for completion of patient consent forms, provide the patient with a copy of the Patient Handbook, and completing an initial individual treatment plan.

b. The initial individual treatment plan is a “preliminary plan” and is primarily focused on the first 30 days of projected treatment. The initial plan focuses on stabilization, with or without medication assistance, and integration into the process of the CDT recovery program. Goals and objectives may, however, continue past the initial 30-day period, and will be continued or closed (or rewritten) as indicated by patient progress.

c. The initial plan presents the patient with the initial pathway of medical and clinical assessment, medication management if offered, and daily assessment of signs and symptoms of withdrawal. The preliminary plan covers the basics of medication induction, medication effects, financial responsibility, and delineation of the various activities a patient will attend during the program, including clinical appointments for treatment. As with all CDT treatment plans, it is required that the plan be signed by the Counselor, Medical Director and Clinical Supervisor in addition to the patient.

d. Treatment planning is an ongoing process of assessment, reassessment, evaluation of progress and redesign of the treatment/recovery plan. Because it is dynamic, with a beginning, and, hopefully, an end, transition planning (sometimes called “aftercare” planning) requires attention from the earliest stages of treatment planning. By determining how the patient will transition through our program, it identifies and clarifies the individual’s expectations for treatment early on. Conflicts over what the treatment team believes is appropriate versus what the individual wants should be identified during this point of treatment planning. Thus, potential conflicts become treatment issues. This initial treatment plan considers these assessments and patient expectations and indicates a projected length of treatment by establishing one of three program alternatives.

Short Term Detoxification

This level of care is utilized for those with a brief addiction to opioids. Those with longer standing addiction are at high risk of relapse if detoxified in this fashion.

Maintenance Treatment

This is the preferred level of care for chronically addicted opioid addicts. (MUST have at least a one-year history of addiction).

The initial plan should also address any critical patient problems or crisis situations that exist or that emerge during the assessment process. Such problems should be added to the problem list as they are identified. The treatment plan should be expanded to include these issues and appropriate strategies developed for their resolution. The treatment plan form will be used for documenting such plans as the plan is developed. The treatment plan forms have been designed to document one problem and the accompanying plans so that the formulations are clear, flowing in a natural progression and separate from each other.

a. Successful completion of Medically Supervised Withdrawal.
b. Stability in psycho-social functioning.
c. Completion of a plan for aftercare and ongoing support.
d. A commitment to abstinence from illicit or mood-altering drugs.Categories of discharge are as follows:1. Program Completion
Individuals who have successfully completed the program and have completed medically supervised withdrawal MSW from medication Treatment Completed. Such individuals develop, with their Counselor, an Aftercare plan to address the issues of continuing needs for support. Most frequently individuals in this category are referred to self-help groups such as NA or AA.2. AMA
Patients have the right to be withdrawn from medication and seek treatment in other settings or other approaches even when the Physician and clinical staff believe this not to be the best course of treatment. Such individuals sign an AMA form and begin MSW. Such individuals develop, with their Counselor, an Aftercare plan to address the issues of continuing needs for support. Patients in this category are informed of procedures for readmission.

3. Transfer
Patients have the right to transfer to another clinic whether due to relocation issues or their desire to work with a different treatment environment. The assigned counselor is responsible for assisting those who wish to transfer.