Service recipients participate in an individualized, strengths-based, culturally responsive, comprehensive psychosocial and medical
assessment.
Note: Refer to the
Assessment Matrix for additional assessment
criteria. The elements of the matrix can be tailored according to the needs of specific individuals or
service design. Individuals readmitted within 30 days are not required to undergo a formal re-assessment.
At admission, a physician, or another qualified medical practitioner, documents that opioid treatment is medically necessary based on a determination that the individual:
- has been dependent on opiates for at least one year before admission, except in extenuating circumstances set forth in federal, state, and local law or regulation; and/or
- is physically dependent upon a narcotic drug, using accepted medical criteria, such as those listed in the Diagnostic and Statistical Manual for Mental Disorders.
Interpretation: Extenuating circumstances may include release from penal institutions, pregnancy, and prior treatment history.
The information gathered for assessmentsis strengths-based, comprehensive, directed at concerns identified in the initial screening, and limited to material for meeting service requests and
objectives.
A physician assesses each service recipient to ensure that he or she has voluntarily chosen opioid treatment and understands all relevant facts concerning the use of opioid treatment
medication.
Each person admitted to the program receives a medical evaluation by a physician, or a qualified medical practitioner under the supervision of the medical director, within 14 days of admission that includes, but is not limited to, the following baseline information:
- medical history, including history of narcotic dependence;
- evidence of current physical dependence;
- laboratory examinations, including a serological test for syphilis, a tuberculin skin test, and a toxicology test to analyze drug dependence;
- determination of the presence of infectious diseases or organ abnormalities;
- determination of vital signs, general appearance, and condition; and
- family, economic, occupational, and housing needs.
All individuals are screened for:
- high-risk behaviors related to HIV/AIDS, sexually transmitted diseases, multi drug-resistant tuberculosis, and other infectious diseases;
- patterns of other drug use;
- presence of co-occurring health and mental health conditions; and
- issues related to criminal activities.
Interpretation: Individuals identified as having mental health needs receive integrated treatment directly or through referral to a cooperating service provider.
Assessments are conducted in a culturally responsive manner to identify resources that can increase service participation and support the achievement of agreed upon goals.
Interpretation: Culturally responsive assessments can include attention to geographic location, language of choice, and the individual’s religious, racial, ethnic, and cultural background. Other important factors that contribute to a responsive assessment include attention to age, sexual orientation, and developmental level.