DCF Request: Case Study

B) According to the “ Journal of Medical Ethics” it may not be that simple to assist with

The patient asked this writer if this writer cannot talk to her mother and advocate for the patient to the clinic's TEAM about the urgency of getting her bottles. This writer was willing to talk to the patient mother and will try again, to advocate on the patient behalf to get her bottles. However, addressing the mental health portion, the patient stated she has to figure something out about the transportation barrier as no scheduled has been made with CHR due to her barrier. Please note, the patient is no longer seeing Dr. Kuru as the psychiatrist no longer works for CHR. The patient prescriber for her medication is her

Counselor flagged Pt. on the AMS computer system to meet with this writer before dosing. Pt. met with counselor discussed and completed an AMS Dose evaluation to increase her dosage of methadone because she isn’t feeling well and experiencing side effects. Counselor prompted Pt. to talk about her pregnancy, medical appointment and to schedule her monthly therapy session with this writer. Pt. reported that her pregnancy is going well and she is having a lot of appointments at the Bay health hospital in Dover, DE. Pt. stated that they can’t determine the baby sex because her baby has the legs cross. Counselor told pt. that the Bay Health Hospital has a good nicu care unit and professional doctors. Counselor asked Pt.is

The patient self-admits that she was not always compliant with her appointments due to changes to her work schedule since the month of December of 2016, but shared this information with her counselor. The patient is requesting to be reassigned to another counselor as she reports of not having a positive rapport with Cherron. Cherron was advised based on the patient complaint that it will be addressed with the Clinical Director based on her request to be

3. The patient had informed this writer initially of his goals of wanting to return back to the Hartford Dispensary due to the length of time he has been with the clinic and his positive rapport with his prior counselor at the other facility. The patient was compliant with his individual sessions with this writer and provided cancellation if unable to attend the session in the meantime while he awaits on the process of completion with his intake at Hartford Dispensary.

He reports the patient’s roommate was subsequently evicted from his home after the landlord inquired about the ambulance visiting. He reports he contacted her father concerning the patient residing within the family home, but the father has said no. In addition, he reports he has attempted to contact her uncle but has been unable to make contact with him. He reports he has attempted to make contact with her said friend who is considering allowing her the opportunity to reside with her but she has not answered her phone and he has been unable to leave a voice message. He reports no one wants her in their home, and the patient has “burned her bridges” with family members. He reports her family would benefit from counseling. In addition, he reports her family has high expectations of CPS. He reports her current case was not going to close within 12 days of 06/30/2017. In addition, the case will not

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

Frankie Tilmon continues to be out of treatment compliance. Frankie has missed his last four appointments, 7/2/15, 7/9/15, 7/16/15, and 7/30/15. Frankie contacted this provider on 7/6 to apologize for missing his appointment on 7/2 and was reminded of his next appointment on 7/9, which he agreed to attend. On 7/15 Frankie contacted this provider to apologize for missing his treatment appointment on 7/9 and agreed to make his appointment the following day, which he failed to appear for. On 7/16 Frankie contacted this provider to again apologize for missing his appointment and wanted to confirm his next scheduled appointment day/time. I told Frankie that his appointment day and time has not changed; it was on Thursdays at 4pm. Frankie told

Hair is expected to submit medical document for her and her child by 02/2017. Ms. Hair failed to submit updated medical documentation. Case Manager reminded Ms. Hair if she failed to submit the document required on her next meeting it would be considered non-compliance and a warning for non-compliance will be issued. Ms. Hair stated that she was aware.

D-Spoke with the patient as she was being curbside dose. This writer reiterate about TEAM recommendation, at which the patient declines the notion of being placed in a skilled nursing facility due to her medical issues.This writer informed the patient that her level of care is inappropriate for this treatment and a high level of care would be more efficient. According to the patient, she's working with Chrysalis and is willing to sign an ROI for this writer to communicate with her case worker Anthony, aka Tony. Reported stable on her dose.

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

Service Coordinator (SC), Jennifer Stoker met personal staff, Aiesha Crayton at the home of consumer Jonathan .SC asked was Jonathan meet his outcome would like is medical expenses to cover. Aiesha noted he has Medicare and Medicaid which cover all his medical expenses. SC asked if money covering his want and needs. Aiesha noted yes. He wants and needs are being meet. Jonathan wants his cell to be paid every month. Aiesha noted he cell is being paid every month. SC asked is Jonathan maintain good health. Aiesha noted he when to his PCP on June the 1st. She noted he is health and there was no change in medication.

The patient was placed on HOLD to see the writer to address his non-compliance with treatment. The patient was reminded about his Step 3 of the patient engagement. According to the patient as the writer reviewed the patient case history of his no show for counseling, group attendance, and continuously AWOL, the patient only response was, " I, know." The writer then inquired of the patient efforts to engage in mental health services through ICRC. The patient admits that he haven't done the intake when the deadline was extended for the third time. The writer discussed with the patient about the risk of facing an intent to discharge due to his non-compliance and addressed alternatives such as suboxone and transferring to a clinic in Massachusetts to accommodate the work location. The patient declines the writer's suggestion as he wants to remain with HCRC-Hartford due to the positive treatment and said. " You guys really care....I do not want to be discharge.....I, mean what is the process of the intent of discharge?" The writer explained to the patient about the appeal process as his record will be reviewed by the Practice Manager to determine as to whether or not to forward with the discharge or the discharge to be overturn.

D-Met with the patient as she placed on HOLD due to recent concern of her overall well-being reported by Nurse Frank as he reported to this writer yesterday of his concerns that the patient's boyfriend is refusing her to increase on her methadone due to an agreement and the patient tends to appear emotional. Upon meeting with the patient, the patient immediately knew why she is meeting with her and started to get emotional. Denies feeling SI/HI. According to the patient, she had an agreement with her boyfriend of which she agreed to increase her dose up to 55mgs as her boyfriend will closely monitor her recovery. The patient does not feel unsafe around her boyfriend as she reported. This writer strongly advised the patient that she has rights to her own recovery process because it's her in the recovery and seeking treatment, at which the patient agreed. But says, "I am fine with my current

The patient arrived on for his counseling session. Reports stability on his current dose and denies the need for a dose increase or decrease when offered by the writer. The patient was made aware that he will be reassigned to counselor, Scott effectively immediately as his new assigned counselor will schedule his next session. The patient reports of no update with his medical pertaining to a referral to another PCP as he is currently still seeing the same medical provider.