Reflection On Rt's Medication Management Placement

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

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

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

:01 PM-3:00 PM SC received a telephone call from Pa states that she was discharged to home on 1/22/2016 from PowerBack Rehab, and she wants her services to start again. SC asked Pa when she was discharged from the hospital. The Pa reported that she was discharged to rehab on 12/22/2015. The Pa stated that she needs someone to help her with her personal care and home management. SC asked Pa where Quintella is (Pa’s DCW/dtr). The Pa reported that she don’t know but she is gone and not coming back. SC informed Pa that the SC spoke with the DCW/dtr Quintilla Bentley on 1/14/2016 and she reported that she (Pa) was scheduled for surgery on the same day 1/14/2016. The Pa exclaimed that whatever she reported was not true. The Pa reported that she had surgery on the 12/14/2015. The SC

Action: CSP and Clinician introduced new case coordinator to MHS. CSP, Clinician and MHS discussed missed medical appointments. MHS explained the Medicaid transportation services did not pick her and the youth up for the scheduled appointment. MHS stated she received the letter from the DSS worker for Juliet’s medical physicians. CSP explained MHS must get the MUSC summaries updated with the correct information. MHS cannot no longer receive verbal instructions. MHS, Clinician and MHS discussed Juliet’s WIC appointment and the use of power milk. MHS explained Juliet is making milestones and responses to the voices of family members.

Michael escorted patient #1974 to Supervisor office as the patient appeared to be upset with regard to her recent HOLD. According to the patient, she complained about her assigned counselor placing her on HOLD for unscheduled sessions and this has occurred on two separate occasion. The patient then reports that on 05/8/2017- an appointment was schedule, but the patient cancelled and was told by Michael that she will receive a phone call to reschedule the appointment but no call was made. In addition, the patient shared that her assigned counselor did not fax her UDS result to DCF/Housing Worker. The patient requested to be reassigned with a new counselor. This information was relayed to Michael pertaining to the patient response. According

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

Intervention/Response: CM received a called from Corporal Williams on Prichard Police Department stating she needs to meet with consumer. CM informed Corporal Williams she will give her a call once she makes it to consumer home. CM traveled to consumer home for the purpose of monitoring and assessing needs. CM was accompanied with CM Shamaiya Williams. CM arrived at consumer home and knocked on the front door. Consumer answered door and met with CM on the front porch. CM contacted Corporal Williams and informed her she was at Consumer home. While waiting for Corporal Williams to arrive CM and consumer discussed consumer medications regimen. Consumer has been taking her morning medications. CM educated consumer on the importance of her taking

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.

(S): Writer met with the consumer on Thursday, 11/9/17 at the consumer home. The consumer had just return from the hospital. The writer asks the consumer why he went to the hospital. The consumer states his legs was hurting him and he needed something for pain. The writer discuss with the consumer about scheduling an appointment with his primary care physician for a complete physical and to let his doctor. The writer did discuss with the consumer about going to the hospital vs scheduling an appointment with his primary care doctor. The writer also inform the consumer that he is schedule to follow up with the doctor on Friday, 11/10/17 at 10:00am. The consumer denied any sleep and appetite problems.

D-The patient requested to see this writer, at which this writer agreed. The patient appears worrisome. The patient asked for assistance by this writer to help fill out an application for the probate court to file a custody petition for her grandson. This writer asked the patient if she had asked her DCF worker for help and the patient response was yes. The patient inform this writer that her DCF worker does not help her with anything or even have the answers to her questions regarding to her grandson care. This writer agreed to help the patient as much as possible and struggling urges the patient to have someone at the Probate Court to view the application to file a petition. The patient asked questions to this writer about receving financial assistance for her grandson since the patient needs help with the child basic needs. The patient been using her benefits from the state to care the child and is only

On September 14th a child showed up with her mother for an outpatient procedure. The minor was checked in at registration and then proceeded back to prepare for surgery with the pre-op nurse. At this time the mother further explained that she would be leaving the facility but gave contact information to get a hold of her once the procedure was complete. This information was placed on a note pad and note in the patients file. Once pre-op was complete the child was taken back to the OR were she was cared for by the OR nurse. After the procedure was complete the recovery nurse ensured the patient started to wake and then handed off to the discharge nurse. After waiting for the mother to return for about a half hour the patient started to become upset. Looking in the waiting area and not being able to locate the mother the, once the discharge nurse got a call from security that the father had shown up the nurse gave discharge instructions to the father and allowed the father to take the child.

Counselor met with Pt. for his monthly individual session. Counselor and Pt. discussed his progress in treatment, any medication issue, any triggers and acceptance of his TX plan. Pt. signed his Record Service sheet. Pt. indicated that he does not attend the clinic Tuesday, Saturday and Sunday and he likes having more time in his schedule because he likes to take care of his business and different errands. Pt. verbalized how hard it is to stay away from his business because worried about his employees and clients. Pt. stated, “The business is like my kid,” Pt. spoke about how he is thinking about opening a second shop around this area. Pt. commented that he isn’t experiencing serious side effects and prescribed medication is working well. Pt. informed this

This writer agreed to meet with the patient as she missed group and her scheduled individual session with this writer. The patient apologized to this writer for her absence and then reports about transportation issue. This writer discussed with the patient about her MVA this month on the 18th and the status of obtaining a police report. The patient reports, " I can get the police report by the next appointment. I just have to go to my insurance company that isn't too far from where I live to get a copy of it."

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