U.S. Probation/Pretrial Treatment Service Providers Training

12/17/09

Referral Process

Procedure and Documents

USPO/USPSO calls to schedule initial intake appointment for offender/defendant

USPO/USPSO forwards:– Program Plan– Aftercare Case Summary– Release of Confidential Information Form

Program Plan

Review to program plan to ensure all necessary codes are included

Have offender sign Send original back to

officer and retain copy in your file

Program Plan

Do not provide services not listed on the Program Plan, you will not be paid

Initial intake can be billed as 2 units of 2010 If transfer from one vendor to another, 1 unit

of 2010 can be billed if authorized by USPO in “Instruction Section”

Release of Information Form

Ensure form is filled out completely

Offender/defendant signs

Witness signs Original is returned to

USPO/USPSO Copy retained in your

file

Urine Specimen Collection Procedures

UA Collection

Although the Statement of Work establishes guidelines for unobserved urine collections, this method is highly discouraged by the U. S. Probation Office.

•Never underestimate what an addict will do to conceal drug use or try to “beat” the drug test.

•Temperature strips must be available for unobserved urine collections

Call in Procedures

Use a code-a-phone/message recorder system

Update message daily Do not give more than 12 hours notice

Requirements

Testing must occur 7 days a week including holidays Offenders/defendants must be tested at least one

weekend per month Back-to-back testing (two consecutive days) must

occur monthly for Phase I Collection of urine specimens should be observed One unobserved specimen collection is allowed per

month, if absolutely necessary

Daily Treatment Log

Offender/defendant signs in and out for each service

Each service must be listed on a separate line (i.e counseling and testing)

Vendor also signs each entry

Forward DTR with invoices monthly

Urine Collection-Step 1

The subject should be escorted from the waiting area to the collection area by the collector.

Be cognizant of body language and potential efforts to conceal a “cheating” device.

The collector and the subject are the only people present in the collection area at this time. Multiple collections should not occur at the same time.

Urine Collection –Step 2– The collector shall obtain

supplies from a secured area in view of the subject.

– Chain of Custody (COC) form

– Specimen ID labels– Red tamper evident seal– Specimen bottle– Wide-mouthed cup– Tamper evident bag

Urine Collection –Step 3– The collector fills out the top portion of the COC

form (subject’s name, PACTS number, supervising officer, collection date/time, and medications).

– Verify information on pre-printed forms.

Collectors shall:

Use a clinical refractometer on all specimens Ensure specific gravity (s.g.) is 1.003 or higher If s.g. is lower, allow 1 hour to collect another sample

at no charge Ensure sample is a minimum of 35 milliliters Permit no more than 2 hours to provide a valid

sample if stall occurs

Collectors shall (con’t):

Use Non-Instrumented Testing Devices (onsite) for all testing

Allow 15 minute grace period before reporting a “no show” (until 9:15 am)

Collect urine between the hours of 5:00 am-9:00 am only

Do not allow waiting period to exceed 15 minutes

Collectors shall (con’t):

Do not disclose the schedules of testing or number of tests to offenders- defendants

Do not share personal work schedules Meet monthly with officers in person or via

telephone Be available by phone, cell phone and/or

email

Urine Collection –Step 4

The subject signs a specimen ID label. The subject affixes the signed specimen ID

label to the bottle, and affixes the matching specimen ID label to the COC form.

Urine Collection-Step 5

– The collector maintains control of all supplies and escorts the subject into the testing room.

– Ask the subject to remove any bulky (concealing) clothing, and to roll up sleeves so that wrists/forearms are in clear view.

– It may be necessary to have subject adjust clothing in order to adequately determine that a device is not being concealed on his/her body.

Urine Collection-Step

– The subject will rinse hands with cold water (no soap) and dry them thoroughly.

– Purpose of rinse is to eliminate any agent the subject may use to contaminate their urine.

Urine Collection-Step 7

The collector hands the labeled bottle to the subject and positions himself in a manner to directly observe urine leave the body and enter the specimen bottle.

Urine Collection-Female

A clean, wide-mouthed disposable cup is used to catch urine. The urine is then transferred to the specimen bottle by the subject.

Urine Collection-Female

Because it may be impossible to see urine leave the female body and enter the disposable cup, other procedures must be employed to insure a urine substitution does not occur.

•Ask the female subject to hold the cup with one hand, and place the other hand against the wall, or in clear view away from the cup.

•Ask the female subject to begin the flow of urine, stop the flow, and resume the flow, insuring that urine is actually coming from her

Urine Collection-Step 8

After urine is collected, the subject places the cap firmly on the bottle to prevent leakage.

•The collector should not handle the bottle, especially if it is not capped.

Urine Collection-Step 9

Positive On-Site

Complete On-site Chain of Custody Form Have offender/defendant fill out comment section

and sign Include Kroll Chain of Custody Form # on Onsite

Chain of Custody Form Notify USPO/USPSO via fax immediately of positive

on-site test result Do not bill for both 1010 (lab) and 1011 (onsite), it is

one collection

Positive On-Site (continued):

Follow proper procedures for packaging and mailing specimens as listed in the SOW

Fill out Kroll Chain of Custody Form Do not include s.g. on Chain of Custody form Do NOT request primary or secondary test panel Request “confirmation only” and list presumptive

positive test(s) Upon receipt of lab result, fax results (positive or

negative) to USPO/USPSO immediately

Urine Collection-Step 10

– The subject shall place the UA specimen into the pocket containing an absorbent sheet of a tamper evident bag.

The collector shall fold the form, place it into the document pocket, tear adhesive lining, and fold adhesive flap over front pocket to insure a secured seal.

Urinalysis Log

All specimens must be listed on the UA log

UA Log is submitted monthly with the invoice

May alter your UA Log with approval from Substance Abuse Coordinator

Completing the Laboratory Chain of Custody Form

Must be legible Must print Must keep

letters/numbers within the boxes provided

Must include officer initials

Must include PACTS number

Incorrect COC

Primary test requested with confirmation

Names not in fields Incorrect officer initials

Incorrect COC

PACTS number not inside boxes

Name in incorrect field Requested 2 tests Specific gravity listed

on form

Illegible No collectors name Specific gravity listed

Storage and Delivery

– The bagged specimen shall be placed into a shipping box and kept in a secured area.

– UA specimens must fit comfortably in the box and should not be packed so tightly as to compromise the tamper evident seal, COC form, or box itself.

– Follow proper FedEx procedures for shipping clinical specimens.

Behavioral Issues

Please refer offender to the US Probation Office if they are found with any type of device

DILUTE URINE

– Dilute urine can be an indication that a subject is attempting to “flush” his/her system with excess fluid to avoid drug detection.

– Products sold to “beat drug tests” commonly use flushing as the method to avoid detection.

– It is important to note on the COC form if urine appears dilute.

– If a pattern of providing dilute urines is noticed, the collector should communicate this with the officer.

Stalling & Subsequent Attempts

– If the subject is unable to provide a sample, the collector shall complete the appropriate section of the COC form noting the “stall” and fax it to the supervising officer. The bottle should be disposed of in a trash receptacle in a secured area.

– DO NOT re-use the first form nor the bottle for any future collection, including a subsequent attempt by the same subject. A new form and a new bottle must be used.

– If the subject is able to submit a sample in a subsequent attempt on the same day, the COC form indicating the stall should be destroyed.

NO TEST

– Sample arrives at on-site lab without the COC form– Tamper evident seal is broken or missing– COC form is not signed by either the collector or the subject– Specimen ID on bottle label and COC form do not match – No initials by subject on red tamper e. seal– White specimen ID label overlaps red tamper e. seal (AKA

Incorrect Collection Procedure)

BREATHALYZER

Alcohol Breath Testing

Alcohol testing no longer by urine Do not exceed breathalyzer frequencies

listed on Program Plan Vendor responsible for training staff and

calibration of units Must begin on January 1

Alcohol Breath Testing

Notify USPO/USPSO immediately of positive reading and document on Chain of Custody form

Include all breathalyzer results on Monthly Treatment Report

Sample Breathalyzer Log

Monthly Treatment Report (MTR)

Testing Information must include:

Days of the week Type of test (on-site vs

lab) Result of test(s) Specific gravity medication (if

applicable) Bus tokens/passes Co-payment

MTR Comment Section

If receiving more than one service (i.e testing, individual or group counseling, IOP), progress of all treatment must be combined and summarized

Summary should be informative and specific to the individual client

NO canned language

Notification Reports

Vendor responsible for creating own notification reports (for review by Substance Abuse Coordinator)

Must include all pertinent information– Type of violation

FTA (counseling/testing/intake) Stall/ low specific gravity Positive result (onsite, breathalyzer, or lab)

Notification timelines:

Positive Test – Due immediately

Failure to appear for services– Due immediately

Discharge Summary– Due within 15 days

Supplies and Inventory

Supplies

Supplies from USPO/USPSO include:– Sweat patch – On-site (NIDTs) 6-panel and single MDMA– Kroll laboratory

Bottles Baggies Chain of Custody Forms Mailing supplies

Must keep USPO and USPSO supplies separate

Supplies (con’t)

Probation Onsite tests, and laboratory supplies are ordered through Carla Garcia carla_garcia@cacp.uscourts.gov (562) 980-4112

Pretrial supplies are ordered through Brenda Mercado brenda_mercado@cacpt.uscourts.gov (213) 894-3464

Order before you run out May take 2 weeks (business days) to receive

supplies

Inventory

Monthly probation inventory must be submitted by the 10th of each month to Substance Abuse Coordinator- Jennifer Smith

Monthly pretrial inventory must be submitted the 10th of each month to Senior USPSO Adriana Corona-Buergo

Inventory includes # of devices received and used during the proceeding month

Sweat Patch Log

Must be sent to Substance Abuse Coordinator Jennifer Smith by the 10th of each month

Termination of Services

Program Plan does not require offender/defendant signature

Include in your file If counseling provided,

must complete a typed discharge summary to USPO/USPSO within 15 calendar days

Monitoring

Will be reviewed at least two times the first year of the contract

If unsatisfactory rating, you will have a follow up review

Deficiencies can result in a Cure Notice that requires a formal response

You will be held to the standards in the proposals you submitted

SWEAT PATCH TRAINING

For outpatient testing only Only for staff never trained before Approx. 1 hour Test at end Will receive certificate in mail

Questions??Comments