10-011 E. Substance Abuse Services

 

Table of Contents

The Substance Abuse Services section includes the following information:

 

Topics

Background

Substance Abuse Services

Screening Procedure

Referral for Assessment Following the 27-62

Referral for Assessment at Other Times

When a Participant is in Treatment Prior to WTW

Enrollment in Treatment

Failure to Comply with Treatment Plan

Termination of Treatment Plan

Attendance Monitoring

ECM Action

WTW Plan Hours

WTW Participation Documentation

WTW Compliance for Participants in Treatment

AOD Forms

 

Background

State regulations require counties to make substance abuse treatment services available, when necessary to enable participants to make the transition from welfare to work.  If a participant is determined to have a substance abuse problem, counties must offer the individual two opportunities to receive substance abuse treatment.  Counties may offer additional treatment opportunities as deemed appropriate.

 

Substance Abuse Services

Employment Sites shall provide a workspace and private interview room for the Alcohol and Drug Services (ADS) contracted Alcohol and Other Drugs (AOD) Specialist who is required to be co-located on site full-time.  All CalWORKs recipients referred to Welfare to Work (WTW) are required to complete the Welfare to Work Behavioral Health Screening Tool (27-62) between the time of Appraisal and Assessment or Modified Assessment except participants who:

·       Are full-time employed prior to Appraisal as their only WTW activity;

·       Are unable to come to the Employment Site during regular business hours; and

·       Completed their Appraisal by phone and/or mail.

 

The AOD Specialist is contract by ADS to:

·       Administer the 27-62;

·      Conduct the substance abuse assessment; and

·       Provide case management services for those participants in treatment.  This includes: 

1.    Providing follow up services for 90 days to try to engage those participants who decline treatment;

2.    Monitoring participants who are enrolled in treatment; and

3.    Acting as the liaison between the Employment Case Manager (ECM) and the treatment provider.

 

Note:  If at any time it becomes known to the AOD Specialist or the ECM that the participant has a felony drug conviction record, that information must be communicated to the Human Services Specialist (HSS) (See Excluded Persons).

 

Screening Procedure

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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ECM must refer participant to the on-site ADS AOD Specialist for administration of the 27-62, at the time of Appraisal or another time mutually agreed upon by the AOD Specialist.  The Employment Sites and the AOD Specialist may develop a set schedule of days and times when the 27-62 can be administered by the AOD Specialist.  See steps below for the AOD Specialist screening procedures:

 

Step

Action

1

Administer the 27-62;

2

Document participant’s answers on the 27-62;

3

Document on the 27-62 other indicators and/or symptoms of substance abuse observed;

4

Notify the ECM the screening results:

 

If……

Then……

The participant is not referred to AOD services,

provide the ECM the Welfare to Work Behavioral Health Screening Result (27-63).

The participant is referred to AOD services,

provide the ECM a copy of the 27-62 and the HIPAA Release.

 

Notes: 

1.    ECM will only administer the 27-62 if the AOD Specialist is not available to do so before development of the WTW Plan (rare or emergency situations only).  ECM to have the participant complete a HIPAA release and follow the ‘Screening Procedure’ step/action steps to administer the 27-62.

2.    Participants fitting the following criteria will not require a referral for further substance abuse assessment:

·        Currently in a substance abuse treatment program; or

·        Participating in the Adult Drug Court Program out of the El Cajon, South Bay, North County, or San Diego Municipal Courts; or   

·        Participating in another court ordered treatment; or

·        Subject to a Child Welfare Services Case Plan, which includes substance abuse treatment.

 

Referral for Assessment Following the 27-62

See steps below for referral procedure following 27-62 administration:

 

Step

Action

1

The on-site AOD Specialist either completes the Drug and Alcohol assessment immediately following administration of the 27-62 or refers the participant for assessment at a different time/location using the Alcohol and Drug Services Assessment Referral Letter (27-65).

·  Assessment appointment must be scheduled within five (5) working days from the date the 27-62 is administered.

·  Form 27-65 must be signed by participant with a copy to participant, ECM, and AOD Specialist.

2

ECM is responsible for monitoring the receipt of the assessment results from the AOD Specialist within seven (7) days from the date on the 27-65 HHSA and if not received, must contact the AOD Specialist to request results of the assessment.

3

AOD Specialist must notify the ECM of the results of assessment immediately following completion of the assessment using the Alcohol and Drug Services Assessment Result and Referral Information (27-326) and indicate one of the following:

·  Participant failed to keep assessment appointment, or

·  Assessment was completed on ________ and the results of the assessment are:

Ø  Substance abuse problems were not found and treatment is not needed, or

Ø  Substance abuse problems are suspected but participant declined treatment, or

Ø  Participant has been referred to a specific facility for treatment.

Notes: 

1)   If participant fails to keep the assessment appointment:

·        ECM must take appropriate steps to determine good cause for non-compliance; and

·        If no good cause exists, determine if the participant is out of compliance with WTW requirements.

2)   Participants are required to attend a substance abuse assessment if substance abuse is suspected.  Participants cannot be required to participate in treatment.  However, a participant who declines treatment may not use substance abuse as a basis to claim “good cause” for any reason.

·        For example:  A participant who declined treatment and failed to attend Job Club because they were hung over would not have “good cause” for their failure to attend Job Club.   

 

Referral for Assessment at Other Times

Referral for Assessment can occur any time ECM suspects a participant has a substance abuse problem.  See below for referral procedure at a time other than initial screening.

 

If…

Then…

Both participant and the AOD Specialist is available

ECM will request that AOD Specialist see participant to either:

·  Complete assessment; or

·  Schedule an assessment appointment.

AOD Specialist is not available

ECM must:

·  Complete form 27-65, give one copy to participant, and fax or hand deliver a copy to the AOD Specialist; and

·  Instruct participant to contact AOD Specialist within two (2) working days to make an assessment appointment.

Participant fails to schedule and attend assessment

Participant is subject to a “good cause” determination.

 

When a Participant is in Treatment Prior to WTW

 

 

 

 

 

 

 

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When a WTW participant is currently in treatment pursuant to a court order, Family Reunification plan, or appropriate self commitment, an assessment for substance abuse is not required. 

 

·  ECM will coordinate the WTW Plan with the treatment provider

·  Treatment provider will contact appropriate ECM to notify ECM of need to develop or modify the WTW Plan for the participant

·  ECM must notify AOD Specialist of participant’s court ordered or self commitment in order for AOD Specialist to monitor treatment status and attendance with treatment provider.

 

Note:  Employment Sites in each region shall identify a contact name and telephone number that will be shared with community based agencies eligible to claim WTW substance abuse funds.

 

Enrollment in Treatment

Following substance abuse assessment and determination that treatment is needed, the participant who is willing to participate in treatment is referred to a substance abuse treatment center by the AOD Specialist.

 

Substance abuse treatment services include:

·  Evaluation;

·  Treatment;

·  Substance abuse programs; and

·  Attendance monitoring and documentation (includes notification to ECM of non-participation).

 

Step

Action

1

AOD Specialist sends the treatment center a copy of the 27-326 to inform them that a referral has been made.

2

The treatment center completes a treatment intake on the participant and sends enrollment information including the Weekly Treatment Plan Schedule to the ECM via the AOD Specialist using the Alcohol and Drug Services Enrollment and Termination Reporting Form (27-327).

3

ECM shall incorporate the Weekly Treatment Plan Schedule into the participant’s WTW Plan.

 

Failure to Comply with Treatment Plan

Any time the treatment provider determines that a participant has failed to comply with the terms of the treatment plan, the treatment provider must contact the ECM via the AOD Specialist within one (1) working day in writing by either fax or mail.

 

Termination of Treatment Plan

Upon termination of treatment, the treatment provider will fax or mail form 27-327 to the appropriate ECM via the AOD Specialist to inform them via the comments section of the form that the treatment plan has been terminated.

 

Attendance Monitoring

Once participant has begun treatment, the treatment provider will mail or fax the Alcohol and Drug Services Monthly Progress Reporting Form (27-328) to the ECM via the AOD Specialist to indicate participant’s attendance in their treatment program.  An attendance form:

·  Is required for all participants enrolled in treatment in the previous month;

·  Must be received by the ECM by the fifth (5th) working day of the month following the report month.

 

ECM Action

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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·  ECM includes recommended substance abuse treatment plan/program and incorporates supportive services into participant’s WTW Plan.

·  Upon termination of WTW case, ECM must immediately notify the treatment provider via the AOD Specialist using the Welfare-to-Work Case Termination Notice (27-66).  The 27-66:

Ø  May be mailed via the AOD Specialist up to the 25th day of the termination month to Mental Health Systems, 3340 Kemper St., Suite 103, San Diego, CA 92110;

Ø  Must be hand delivered or faxed to (619) 224-2538 via the AOD Specialist after the 25th day of the termination month.

 

Note:  A participant determined to have a substance abuse problem who refuses treatment must be offered at least two subsequent opportunities to receive substance abuse treatment.  The ECM may offer additional opportunities any time it is believed the participant would benefit from treatment.

 

WTW Plan Hours

·  Participants cannot be assigned to participate in a “stand alone” substance abuse program for longer than six months unless the participant is in a residential treatment or an intensive day treatment program which requires the participant to remain at the treatment program site, preventing participant from participating in any other WTW activities.  In this case the requirements of the treatment program fulfill the WTW activity requirement (see Exception below).

·  Participants in substance abuse treatment programs which do not require day long or 24 hour on-site participation can continue to participate in a substance abuse treatment program after six months of “stand alone” activity, if the individual is assigned to a second, concurrent WTW activity.  The concurrent activity will be determined by the ECM and participant in consultation with the substance abuse treatment provider.

 

Exception:  If the participant is in a state-licensed residential facility or a certified nonresidential substance abuse program that requires him/her to stay at the program site for a minimum of three hours a day, three days per week, or otherwise not to participate in non-program activities, the requirements of the treatment program shall fulfill the participant’s WTW activity requirement on a case-by-case basis. 

·  The treatment provider must provide written verification that the participant is not able to participate in additional WTW activities for the full 32/35 hours per week;

·  The participant will be credited with the actual participation hours as the State does not allow good cause hours for substance abuse treatment;

·  The participant cannot be sanctioned for participating fewer than 32/35 hours in this exception.

 

WTW Participation Documentation

ECMs are required to document and record in CalWIN a participant’s WTW activity hours on a monthly basis.  Upon receipt of the 27-328 form provided by the AOD Specialist, the ECM is to complete the following actions:

 

Step

Action

1

Review form 27-328 and determine if participant’s treatment progress and monthly attendance hours are satisfactory.  

 

If participant’s progress/hours are satisfactory, proceed to step 3.

2

If participant’s hours do not meet 32/35 requirement, Good Cause evaluation can be made by the ECM.

 

Reference: CalWORKs Program Guide Section 10-020 B. Good Cause for Not Participating.

3

Contact to the AOD Specialist can be made to follow up on participant’s treatment progress and/or monthly attendance hours.

4

Complete a narrative in CalWIN Case Comment to include activity information documented on the 27-328 form.  The Case Comment entered by the ECM is required to list all documented activities the participant may have completed while in the Substance Abuse Services (SAS) activity component. 

 

Case Comment Example:  27-328 received from AOD, verified client participated 136 hours of SAS for the month of 10/2011 in the following SAS activities:  42 hours of treatment, 45 hours of supervised job search, and 49 hours of work experience. Attendance tab updated, 27-328 filed in case folder.

5

Retain the 27-328 in the WTW case folder.

 

Note: Alcohol & Drug Service providers offer activities in participant’s treatment plans that may include supervised job search, work experience, job skills training, etc.  ECMs are to document all activities reported on the 27-328 form under the SAS component, ECMs are not to add these as additional activities in CalWIN.

 

WTW Compliance for Participants in Treatment

 

 

 

 

 

 

 

 

 

 

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·  If a participant’s WTW Plan includes assignment to a treatment program, an ECM may determine that participant is out of compliance with his/her WTW Plan when, in consultation with the treatment provider via the AOD Specialist, it is determined that the participant has failed or refused to participate in treatment without good cause.

·  When the ECM determines that a participant is out of compliance with a WTW program requirement and:

Ø  Participant is in a substance abuse treatment program as a requirement of the WTW Plan; and

Ø  The program requirement that they are not complying with is not the substance abuse treatment program;

Ø  The ECM must consider whether the substance abuse problem caused, or substantially contributed to the failure to comply with the program requirement.  The ECM must consult with the substance abuse treatment provider via the AOD Specialist for assistance in making the cause determination.

 

AOD Forms

The Alcohol and Drug Services Forms described in this CalWORKs Program Guide Sections are available to order from iWAY and are on the CalWIN Intranet CalWORKs Client Correspondence WTW section.

 

·        Welfare to Work Behavioral Health Screening Tool (27-62);

·        Welfare to Work Behavioral Health Screening Result (27-63);

·        Alcohol and Drug Services Assessment Referral Letter (27-65);

·        Alcohol and Drug Services Assessment Result and Referral Information (27-326);

·        Alcohol and Drug Services Enrollment and Termination Reporting Form (27-327);

·        Alcohol and Drug Services Monthly Progress Reporting Form (27-328);

·        Welfare-to-Work Case Termination Notice (27-66).