PA-OTP 17: Aftercare and Follow-Up
The agency and the individual work together to develop an aftercare
plan, and follow-up occurs when possible and appropriate.
While the decision to develop an aftercare plan is based on the wishes of the individual unless aftercare is mandated, the agency is expected to be strongly proactive with respect to aftercare planning
The aftercare plan is developed sufficiently in advance of case closing
to ensure an orderly transition.
Aftercare plans identify services
needed or desired by the individual and specify steps for obtaining these services.
An essential component of aftercare is planning for relapse prevention
. The plan also addresses re-entry into maintenance treatment in the event of relapse. Plans for meeting the individualís physical and mental health needs following medically supervised withdrawal should also be indicated, as appropriate.
The agency takes the initiative to explore suitable resources, provides referrals
for continuing outpatient care, and makes contact with service providers when appropriate.
The agency follows up on the aftercare plan, as appropriate, when possible, and with the permission of the service recipient
Reasons why follow-up may not be appropriate include, but are not limited to, cases
where the personís participation is involuntary, or where there may be a risk to the service recipient such as in cases of domestic violence.