Administrative Detox: Interaction Between Patients And The Patient

D- The patient arrived on time for her session and reports being stable on dose and haven't used any illicit drugs. This writer advised the patient that this writer was in fact in receipt of missed phone call about coming to the session at 10:30 am rather than 10 am due to her mother in the process of selling the house. This writer addressed with the patient about letter from CHR from her counselor, Jade Bray stating about the patient non-compliance with her appointment due transportation barrier. According to the patient, she is going through hardship as her mother is no longer taking her to her appointment as the patient says, " She's tired of bringing me everyone, Charlene. She complains about bringing me here and does not understand why I can't even get a bottle...:Like c'mon. What do I have to do?" This writer explained to the patient about TEAM decision, at which the patient disagree with the decision. This writer asked the patient about her "judgement." According to the patient, she feels she is making judgement by not engaging any further altercation with patient at the clinic, dosing daily, coming to her counseling session, and trying to get help from Chrysalis for

D-This writer met with the patient as he was placed on HOLD to address the status of the IOP. The patient provided this writer a paper that was provided to him with listing of IOP for him to explore. The paper shows scribbles of the patient taking down notes about his attempts of who he called. The patient reports Connecticut Addiction Recovery will call him back within 24-48 hours. The patient was able to schedule an appointment with New Direction for May 20th at 7pm; patient spoke with Dan. This writer commends the patient for all of his efforts; however, the patient needs to schedule something earlier than May 20th. This writer asked the patient about ICRC-Coventry House. According to the patient, he called the contact number and showed proof. The patient reports that ICRC gave him two different number and told him to do a walk-in at 8:30am. This writer shared with the patient about a recent conversation this writer had with ICRC. This writer told the patient

D-This writer met with the patient upon her request to complete the dose change request form to lower her dose as the patient experience she wants to start tapering off methadone as the patient haven't used any illicit drugs for several months. This writer completed the dose change request form with the patient pressence and also, assessed the patient that she has not experience any withdrawals since prior increase based on her order history. The patient denies any cravings and withdrawals. Furthermore, while completing the request, this writer learned that the patient is prescribed with Albuterol inhaler and strongly urges the patient to bring in the RX script tomorrow. The patient complained that no one has ever told her of this and this

D-The patient was advised that her bottles are in fact suspended due to the incident that occurred on 02/08/2017 of which the patient needs to accountability of taking a second dose of her methadone even though she has taken her methadone at home. The patient admits her accountability of her actions of taking the second dose. The patient then asked about how she can regained her take home bottles of which this writer explained the policy of take home bottles, referring to the reinstatement process. The patient is referred to attend the Take Home Bottle Group on 03/9/2017 to have her bottles reinstated. Then the patient shared that she wrote a grievance letter and still plans to submit it for the Program Director to review. Furthermore, this

Patient is a 35 year old male presenting to the ED involuntarily as petitioned by his cousin due to threatening to shoot himself with a gun. At the time of assessment, patient denies feeling suicidal or having a plan. When confronted about admitting being suicidal and having a plan to nursing staff and TACT, Mr. Crowson stated "He is here because he is going through withdrawals and his mother is lying." The Mr. Crowson reports in the past year he has lost his father. Mr. Crowson reported wanting to receive Methadone from hospital to help with withdrawal symptoms. He expressed feeling body aches, stomach cramps, chills, irritability, angry, and verbally aggressive behavior. Patient refuses to finish full assessment.

Pt. called this writer to report that he no longer wanted to be in the program. Pt. asked if he needs to sign a Voluntary Request for Termination. Pt. reported that he is going to stop by the clinic to pay his tx services fees. Pt. stated, "I am done wit methadone. I'll go there tomorrow and pay my bill in full." Counselor told that he needs to talk to the head nurse and to sign the AMA Detoxification Agreement tomorrow, Saturday 2/25/17. After discussing this issue with him, he still insisted that he did not want to be in the program and he wants to sign the AMA Detoxification Agreement

This writer and the Program Director met with the patient to share an explanation about dosing time arrangement. According to the Program Director, she provided the patient with an explanation as to why he will have to dose between 9am-11:30am due to patient #394 and her husband medical issues. If the patient returns back to work and needs to dose at an earlier time, the patient must provide proof his work schedule for the dosing time arrangement to be changed again. The patient requested for assistance from the clinic to preschedule his Logisticare transportation of which the Program Director and this writer agreed to assist him with. After the discussion with the Program Director, the patient was not pleased and began to get emotional as he feels victimized again. This writer explained to the patient, the patient reason for the dosing arrangement is due to the allegation and safety reason. However, the patient understood the purpose of the arrangement, but he was more concern about getting the earlier appointment rather than a later time. This reiterate about what the Program Director mentioned about if the need to change the dosing time, the patient needs to provide proof for such request. The patient provided this writer with a copy of his ER visit dated for 02/23/2017 of which the patient did in fact received one pill of Klonopin.

The patient arrived on time for her counseling session. Reports stability on her dose and denies the need for a dose increase when it was offered by the writer. When questioned about what caused her to relapse recently, the patient started to cry as she did in fact regret her recent relapse as she said, " I didn't need that shit.....it didn't do anything for me......I am just tired Charlene, now there is warrant for my arrest and I may be charged with a felony for larceny. I just stressed out because I need to come up with $500 to pay this lawyer to drop the charges to a misdemeanor. The entire cost for the lawyer to represent me is $2500 that I honestly don't have, Charlene." The patient was tearful throughout the session. The writer validated

The patient arrived on time for her counseling session. Reported doing okay with her dose, but wishes she can have an increase as she still experiencing some cravings, but is trying not to relapse. The patient vented about her transportation issues with Logisticare and her ex-husband. Patient says, " I need my rides to be reinstated because I can't keeping back and forth with him.......Did you get my discharge summary?.... Please send it to Logisticare." This writer showed the patient about a recent fax from Hartford Dispensary, referring to her discharge summary and a statement on the clinic's letterhead stating the date of the patient discharge and when she was medically taper off on her dose. According to the patient, she does not want her previous counselor statement to be sent to Logisticare,

D-The patient arrived to the clinic emotional and was advised to see this writer. According to the patient, she's upset about her DCF case, her supervised visit with her son that hasn't occurred yet, loss of employment, and owing $80. 00 for her rent. This writer provided support, validated the patient feelings, and encourages the patient to maintain contact with her attorney and to also, contact 211 for financial assistance. In addition, reach out to the court system to address the violation to her supervised visit as it is not being honored. During the remainder of the session, the patient provided an updated on her mental health provider whereas she is no longer going to Wheeler Clinic due to the travel distance. The patient signed an ROI

D-Met the patient. Please note the patient had dose early during the day and attended the cocaine group. The patient updated this writer on the suggestion she was dealing with yesterday with her new relationship and thank this writer for the advice. She says, " Man, everything is good now...I am good, Charlene." She then discussed her experience at the cocaine group whereas she described it as "okay." She dislike the fact that a patient in the group was making comments about her appearance, but according to the patient she handled the situation well without having an outburst, she only feels that the facilitator could have intervene when the other patient was being disrespectful, but overall the group was "okay" as the patient reported. The

It was reported the facility admitted a resident requiring insulin injections. Resident Gregory Regosin DOB: 6/4/61 was admitted 30 day ago and was diagnosed with diabetes and diabetic neuropathy. According to the reporting party the facility had been administering the resident's medication due the resident inability to self-administer due to the neuropathy. On 7/21/16 the administrator Maria Manimeo became angry with the resident regarding an unrelated issue and declared "you can give it to you yourself" referring to the insulin. The resident disclosed that the facility is administering the medication (insulin), however at time the facility refuses to administer the injection. The resident stated he is unable to administer in injection due

Writer called pt. to see if he needed any case management resources. He asked the writer about the results of his drug screen. Due to the sound and tone of his voice pt. did not sound like his normal self. Writer asked pt. if he needed food or housing. He informed the writer he was fine, he is a survivor. Writer was not able to ask if he needed a shelter to stay. Pt. rushed phone conversation.

D-Met with the patient as she was placed on HOLD to address the positive benzo positive on 08/25/2016 & 08/30/2016. The patient admits to taking Xanax on 08/25/2016, but denies taking oxycondone and benzo on 08/30/2016. The patient believes her heroin was laced with benzos and "oxy" on 08/30 & 08/25. This writer discussed with the patient about the use of illicit prescription and its harmful interaction. In addition, this writer immediately addressed with the patient that if she receives another positive result of benzo that aren't prescribed to her, she will be at risk for an intent to discharge. This writer showed the patient of the patient manuel which was given to her during her intake on page 20 of the non-involuntary termination. Patient

On 9/9/2015, at approximately, 11am, CM met with Esther Toro in the cafeteria, to follow up on Ms. Toro High Blood pressure medication. Ms. Toro was sitting in the Cafeteria and she seems disoriented. She wasn’t oriented to person, place, time and situation, because client stated she didn’t went to the emergency room yesterday. She continues to mentioned she went last week. CM asked Ms. Toro if she was able to pick up her blood pressure medication yesterday, September 8, 20015. Ms. Toro replies “yes” she picked up her blood pressure medication. CM asked to see the blood pressure medication bottle. Ms. Toro shows CM the blood pressure medication bottle with only 9 pills. CM mentioned to the client the bottle stated that she received 30 pills