**TREATMENT PROGRAM**

**RECORD SECURITY**

All client records will be secured to insure client confidentiality.
Federal confidentiality regulations specify the need for adequate
maintenance and safety of client records. The following procedures to
ensure compliance with CFR 42 Part 2 (Attachment O) has been
implemented:

**[Reception Area 8:00 a.m. to 8:00 p.m.]{.underline}**

-   The records are kept in the filing cabinet in the reception area.

-   The records in the reception area that are being worked on are
    placed with the label side down.

-   Clients are not allowed in the reception area. They are asked to go
    to the front window to make their appointments, payments, or
    inquiries.

**[Between 5:00 p.m. and 8:00 p.m.]{.underline}**

-   All open records or terminated records pending review are locked in
    the filing cabinets in the reception area.

-   The records are filed in alphabetical order by type of service.

-   The records that need top be worked on are filed in a separate
    drawer.

-   The filing cabinets and access doors in the large group room are
    locked at all times except when pulling or filing records.

**[Counseling Offices 8:00 a.m. to 8:00 p.m.]{.underline}**

-   The counselors if at all possible should work on one chart at a
    time. If more than one chart is pulled, the records are turned over
    with the name side down to ensure confidentiality.

-   If the counselor is working on one client's chart and another client
    comes into the office, the counselor is to place the chart on
    his/her desk with the label side down until the client leaves the
    office.

**[Between 5:00 p.m. and 8:00 p.m.]{.underline}**

-   The counselor is to bring all records to the front for filing in the
    appropriate file cabinet.

-   No records are to be left in the counseling offices in the evenings.

-   When the office is closed all records are to be located in a locked
    area or file cabinet and behind a minimum of two locked doors.

**[Chart Reviews]{.underline}**

-   Internal and external auditors

-   Auditors will be provided a private office. And appropriate staff
    will pull the necessary records for review.

-   In the event the auditors do not complete the review in one day, the
    records will be stored

> overnight in a locked file cabinet.

**TREATMENT PROGRAM RULES**

**THE CENTER**

**Non-residential Alcohol and Drug Services**

**A. Program:**

> All services provided by the Center are performed by trained staff
> under the supervision of the Program Manager and supervising substance
> abuse counselor. Services provided include individual, group and
> family counseling; assessment and referral services; a wide range of
> specialized recovery and support groups; individual counseling and
> support group services for Drug Treatment clients, Calworks clients,
> and perinatal clients; aftercare; and ancillary services through
> established linkages with other health/human service agencies.
>
> Additionally, the Center conducts alcohol and other drug
> information/education presentations and provides training and
> consultation services for community groups, organizations, and other
> human services agencies.
>
> Clients accepted into the program receive a variety of services based
> upon their needs as identified in the individualized recovery plan
> developed for each client. Estimated time for completion of the
> program is three to six months. The Center provides services Monday
> through Thursday from 8:00 a.m. to 8:00 p.m. and Friday 8:00 a.m. to
> 5:00 p.m. The Center is closed on Saturdays, Sundays and holidays.
> Clients must agree to remain alcohol and drug-free during program
> participation and be willing to accept and abide by program rules.

**B. Confidentiality/Client's Rights:**

> The Center is regulated by the Federal Confidentiality Regulations
> 42CFR, Part 2, and Division 10.5 of the Health and Safety Code which
> ensures that a client's right to confidentiality is maintained.
> Records and information may only be released with the prior written
> consent of the client.

However, in certain instances information may be disclosed without
client consent:

-   When there is a bona fide medical emergency.

-   When scientific research, management audits, financial audits, and
    program evaluations are being conducted, information may be released
    to qualified personnel.

-   When authorized by a court order, information may be released.

-   When there is suspicion of child abuse or neglect, the counselor is
    compelled by law to notify Child Protective Services.

A summary of the Federal confidentiality regulations is available upon
request.

> Client are expected to maintain as confidential the identity and
> content of information shared by other clients in the program.

**Persons requesting services at the Center:**

-   Have the right to be treated fairly regardless of ethnicity,
    religion, natural origin, sex, handicap, age, political beliefs,
    sexual preference or ability to pay.

-   Have the right to speak to a counselor or agency representative
    about other public and private services or resources that may be
    available to him/her.

-   Have the right to an appeal if dissatisfied with any action taken by
    the Center. Such appeals must be in writing within ten days of the
    action and directed to Program Manager, The Center, 658 W. Main
    Street, Merced, CA 95340.

**C. Medical Direction:**

> 1\. The Center is regulated by California Code of Regulations, Section
> 51303 of Title 22.
>
> 2\. The Center has designated a licensed physician as medical
> director. The medical director shall direct medical services, either
> by acting alone or through an organized medical staff.
>
> 3\. The medical director's responsibilities, acting alone or through
> an organized medical staff, shall include:
>
> a\. Establishing, reviewing, and maintaining medical policies and
> standards, which shall be reviewed at least annually and revised as
> necessary.
>
> b\. Assuring the quality of medical services given to all patients
> treated by the clinic.

c\. Reviewing and approving all protocols in the clinic.

> d\. Assuring that at least one physician practicing at the clinic
> shall have admitting privileges to a general acute care hospital or a
> plan as approved by ADP for ensuring needed hospital services.
>
> e\. Assuring that a physician has assumed medical responsibility for
> all patients treated by the clinic.
>
> f\. Assessing the physical conditions of the client within 30 days
> from admission.
>
> g\. Approving and signing each client's recovery plan within 15 days
> of the date the plan was developed.

**D. Criteria for Admission/Readmission:**

> The Center's admission/readmission criteria are applicable to
> individuals with alcohol and/or other drug problems. The Center does
> not discriminate in the delivery of services due to race, color,
> ethnicity, gender, sexual preference, religious creed, physical/mental
> disability, medical condition, age, marital status or ability to pay.

1\. Admission Criteria

> Clients accepted into non-residential Alcohol and Drug Services are
> individuals experiencing life difficulties due to the use of alcohol
> or other drugs. Any individual experiencing alcohol or drug related
> problems might be accepted regardless of age or gender. Clients may be
> self-referrals or be referred for services by the courts, probation
> departments; human services agencies, physicians, mental health
> professionals or other community agencies and/or professionals.

Clients accepted must meet the following criteria:

> a\. A pattern of problematic use that is reflected by one or more of
> the following:

-   Uses alcohol or other drugs at inappropriate times.

-   Frequent intoxication often throughout the day.

-   Inability to limit or stop use.

-   Experiences loss of control when drinking/using.

-   Repeated failures to control use.

-   Needs daily use of alcohol or other drugs for adequate functioning.

-   Social and family relationships deteriorated by individual's failure
    to meet required obligations.

-   Legal difficulties caused by alcohol or other drug involvement or
    criminal activity.

-   Loss of family, friends, jobs, and self-esteem due to alcohol and/or
    other drug use.

-   Displays of erratic behavior due to alcohol or other drug use.

-   Medical problems directly or indirectly attributed to alcohol or
    other drug use.

-   Client has previous pattern of problematic use of alcohol or other
    drugs, is not using at present, but is in danger of relapse.

> b\. Client is willing to accept and abide by program rules and
> policies.
>
> c\. Client has not used alcohol or other drugs for at least 72 hours
> prior to admission.

2\. Readmission Criteria:

Client applying for readmission just meet the following criteria:

> a\. Must have been discharged for at least 14 days prior to admission.

b\. Must meet all admission criteria.

> c\. Individuals who were discharged within 30 days prior to their
> request for readmission are evaluated by the Program Manager. The
> client is provided the opportunity to discuss any problems that may
> have occurred during the prior recovery episode (e.g., program rules,
> hours of operation, counselor assigned to the client). The Program
> Manager will evaluate the prior recovery attempt in an effort to
> determine the suitability of requested services based upon the
> client's needs.

**E. Intake Procedures:**

> The intake procedure of the Center is designed to determine a client's
> eligibility and suitability for recovery services in an efficient and
> humanistic manner. During the entire intake process, care is taken to
> guarantee the rights of confidentiality of all clients in accordance
> with the Federal Confidentiality Regulations 42 CFR, part 2; and
> Division 10.5 of the Health and Safety Code which ensures that a
> client's right to confidentiality

is maintained.

> All clients requesting recovery services are scheduled for an intake
> session with a Center Substance Abuse Counselor. The counselor
> conducts a face-to-face interview and is responsible for the
> appropriate assessment of each individual seeking admission to the
> program. The counselor determines the client's eligibility for
> services in accordance with The Center's admission/readmission
> criteria. During each intake interview the counselor will complete all
> intake functions, which include:
>
> 1\. Client is provided with client's rights information and counselor
> reviews Center policies, rules and procedures.
>
> 2\. The consent to treatment form and appropriate release of
> information forms are explained by the counselor and signed by client.
>
> 3\. Client fees or Medi-Cal eligibility is determined, or the client
> is given assistance in seeking Medi-Cal eligibility.
>
> 4\. The counselor administers the alcohol use profile and a drug use
> inventory to the client.
>
> 5\. The client completes the Medical History form and signs it. (Form
> is sent to Medical Director for review).
>
> 6\. The counselor obtains an extensive client history including:
> alcohol and other drug use history; prior treatment or recovery
> attempts; medical, economic, legal, family, educational, and
> vocational background information.
>
> 7\. The counselor completed the psychosocial interview form.
>
> 8\. The counselor determines the client's eligibility and suitability
> for Center services.
>
> Only after completion of this process and the signing of the consent
> form shall a client be admitted to the program and have his/her client
> file officially opened.
>
> If a potential client does not meet the admission criteria, the
> individual will be referred to another alcohol/drug program with the
> appropriate modality of service required, or referred to other
> agencies for services as indicated.

**F. Code of Conduct and Safety:**

> Clients must agree to the following conditions as a prerequisite to
> admission to The Center:

-   To have respect for each other, each other's personal belongings,
    the facilities, and the employees of The Center.

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-   Violence, threats of violence, stealing, or any form of illegal
    activities are prohibited.

-   To safeguard the confidentiality of each other's identity and the
    information, which is shared within the treatment program.

-   Clients who suspect or know of someone violating these policies are
    required to bring this information to the attention of the staff.

**G. Completion/Discharge Criteria and Grounds for Expulsion:**

> Completion of the non-residential Alcohol and Drug Services will vary
> in time for each client according to the individual's service needs
> and personal efforts, but it is expected to require approximately
> three to six months.
>
> 1\. Criteria
>
> a\. Successful completion will mean that a client has met all the
> goals as established in his/her individualized recovery plan.
>
> b\. Unsuccessful discharge will mean that a client has terminated
> services of their own volition and has not met the criteria for
> successful completion.
>
> c\. Involuntary discharge will mean that the client has been
> discharged as a result of incarceration, assessed as an inappropriate
> referral, or has not complied with or violated the program policies
> and procedures.
>
> d\. Transfer will be used to denote clients who have transferred to
> another agency or program for further alcohol or drug services.
>
> e\. Satisfactory progress will be used to describe clients who are
> actively participating in a treatment program as evidenced through
> regular attendance at scheduled individual and group treatment
> sessions and their continuing achievement of recovery goals identified
> in their individualized treatment plan.
>
> f\. Unsatisfactory progress will be used to describe clients who are
> unsuccessfully discharged, involuntarily discharged, or transferred
> and who [have not]{.underline} progressed in achieving their recovery
> goals.
>
> 2\. Grounds for Expulsion:

Involuntary discharge [will]{.underline} result if:

> a\. A client possesses a weapon.
>
> b\. A client demonstrates violence or threatens violence towards staff
> members or other clients.

Involuntary discharge [may]{.underline} result if:

> a\. A client refuses to participate in program activities.
>
> b\. A client refuses to adhere to program policies and procedures.
>
> c\. A client does not progress satisfactorily towards reaching
> treatment goals.
>
> d\. A client has poor attendance and does not complete make-up
> assignments or misses two consecutive appointments without prior
> notification.
>
> e\. A client is suspected of being under the influence of alcohol or
> other drugs while in the program's facility.
>
> f\. A client fails to attend counseling sessions and has not received
> a minimum of two sessions per 30-day period.
>
> NOTE: A copy of The Center's Program Policies and Procedures Manual is
> available upon client request.

**DRUG COURT TREATMENT FEES**

The treatment provider will charge the treatment fee. Although it is not
a Court fee, it will also be reported to the Judge as part of the
participants regular Progress Hearing. Failure to pay the treatment fee
will result in postponement of progress in the Program from one phase to
the next. In other words, if the participant does not keep current with
treatment fee payments, he/she will not be allowed to advance toward
graduation. Treatment fees vary, based on ability to pay and payment
plans, and can range from \$75 to \$125 per month.

######## TREATMENT CURRICULUM

#### Phase I

1\.

1: Addiction -- A chronic disorder

2: Medical aspects of substance abuse

3: Stress and addiction

4 & 5: Support and/or Parenting

2\.

1: Awareness of Physical Well Being

2: How addiction affects self and family

3: Psychological effects

4 & 5: Support and/or Parenting

3\.

1: Addiction, physical, emotional, spiritual disease

2: Healthy Communication in family settings

3: Long and short term effects of substance abuse on body

4 & 5: Support and/or Parenting

4\.

1: Addiction, shame and guilt

2: Routes of administration and dangers

3: Good nutrition

4 & 5: Support and/or Parenting

5\.

1: How drugs affect your sleep patterns

2: Impact of substance abuse on all aspects of life

3: Denial

4 & 5: Support and/or Parenting

6\.

1: Health, Good hygiene, grooming, and dress

2: What are the negative impacts of drug use on your lifestyle?

3: Responsibility for actions and choices

4 & 5: Support and/or Parenting

7\.

1: Good Habits- acceptance, relaxation, trust

2: Step One -- Claiming My power Preparation for the first Step

3: Honesty reduces stress

4 & 5: Support and/or Parenting

8\.

1: Blocks that cause stress

2: Self-Esteem

3: Doing Activities that enhance self esteem

4 & 5: Support and/or Parenting

9\.

1: Self awareness

2: Step 2

3: Doing clean and sober activities that enhance your self esteem

4 & 5: Support and/or Parenting

10\.

1: Social Well Being

2: Support Groups and Recovery

3: Journaling

4 & 5: Support and/or Parenting

11\.

1: What is my support system?

2: Step 3 -- (Spirituality)

3: Understanding Relapse

4 & 5: Support and/or Parenting

12\.

1: Relapse in process

2: Warning signs- How I behave

3: Sabotaging my Recovery

4 & 5: Support and/or Parenting

13\.

1: My relapse history

2: Warning signs -- How I think

3: PMS and Recovery

4 & 5: Support and/or Parenting

14\.

1: Domestic Violence and Substance Abuse

2: How my body feels

3: Processes involved in relapse

4 & 5: Support and/or Parenting

15\.

1: Attitudes and actions leading to relapse

2: Handling Emotions

3: Healthy coping skills

4 & 5: Support and/or Parenting

16\.

1: Identifying signs leading to relapse

2: Cravings

3: Assertive Living, Confronting Fears, Laughing

4 & 5: Support and/or Parenting

17\.

1: Triggers

2: High risk situations

3: High risk people

4 & 5: Support and/or Parenting

18\.

1: Positive Decision Making

2: Strategies for Coping

3: What is your plan to prevent relapse

4 & 5: Support and/or Parenting

19\.

1: [ATTITUDE]{.underline} along with appearance
[IMPORTANCE]{.underline}!!!

2: Step 4

3 Social support system

4 & 5: Support and/or Parenting

20\.

1: Employer expectations

2: Time management

3: Improving Communication

4 & 5: Support and/or Parenting

21\.

1: Job interview skills -- what is needed

2: Realistic career planning (short term)

3: Where to find a job (available resources)

4 & 5: Support and/or Parenting

22\.

1: Self Value & Confidence

2: Hot to apply for a job

3: Job interviewing (role playing)

4 & 5: Support and/or Parenting

23\.

1: Goal setting

2: Effective Listening

3: Self help goals

4 & 5: Support and/or Parenting

24\.

1: Step 5

2: Human relations on the job

3: Healthy self esteem in relation to job search

4 & 5: Support and/or Parenting

25\.

1: Affirmations

2: Body Language

3: Proprietorship in Recovery

4 & 5: Support and/or Parenting

26\.

1: Step 6

2: Responsibility for your actions

3: Co-Dependency

4 & 5: Support and/or Parenting

#### Phase II

1**.**

1: Increasing Honesty

2: Exercise in Recovery

3 & 4: Support and/or Parenting

2\.

1: Responsibility -- Life Choices

2: Step 7

3 & 4: Support and/or Parenting

3: Openness in Recovery

2: Long term sobriety or just staying clean for 18 months

3 & 4: Support and/or Parenting

4\.

1: Managing Life as a Sober Person

2: Setting Healthy Boundaries

3 & 4: Support and/or Parenting

5\.

1: Respect for Others

2: Step 8

3 & 4: Support and/or Parenting

6\.

1: Making Healthy choices to create a Healthy Family Atmosphere

2: Importance of a Healthy Lifestyle

3 & 4: Support and/or Parenting

7\.

1: Anger a Trigger to Relapse

2: Dealing with Anger

3 & 4: Support and/or Parenting

8\.

1: Honesty with Others

2: Step 9

3 & 4: Support and/or Parenting

9\.

1: Trust and Trustworthiness

2: Developing trust within the Family

3 & 4: Support and/or Parenting

10\.

1: The Dangers of passive aggressive behavior

2: The Assets of Assertiveness

3 & 4: Support and/or Parenting

11\.

1: The downfalls of Aggressive Behavior

2: Focusing on the real issues at hand

3 & 4: Support and/or Parenting

12\.

1\. Communicating openly

2: Step 10

3 & 4: Support and/or Parenting

13\.

1: Taking control of your life

2: Letting go of unhealthy relationships

3 & 4: Support and/or Parenting

14\.

1: Commitment

2: What do I see as a Healthy Relationship?

3 & 4: Support and/or Parenting

15\.

1: Meditation in Recovery

2: Healthy Mind and Body

3 & 4: Support and/or Parenting

16\.

1: Dealing with strong emotions - fear

2: Physical Fitness and Recovery

3 & 4: Support and/or Parenting

17\.

1: Trusting Your Own Judgment

2: Mentoring Others -- Giving Back My Recovery

3 & 4: Support and/or Parenting

18\.

1: What are my Strengths in Giving Back?

2: Step 11

3 & 4: Support and/or Parenting

19\.

1: Barriers in Recovery

2: Exploring Personal Barriers

3 & 4: Support and/or Parenting

20\.

1: My Plan of Action to Overcome These Barriers

2: The Importance of a Strong Aftercare Program

3 & 4: Support and/or Parenting

21\.

1: On going Recovery -- Exit Planning

2: Steps 12

3 & 4: Support and/or Parenting

22\.

1: Exit Planning a review/What is Missing in my plan

2: Develop the missing parts of my exit plan

3 & 4: Support and/or Parenting

23\.

1: On going recovery after the program

2: Sponsorship

3 & 4: Support and/or Parenting

24:

1: Chairing Outside meetings

2: Twelve-Step Maintenance Program

3 & 4: Support and/or Parenting

25:

1: Recreational Activities for a Healthy Recovery

2: Giving Back to Keep Growing in Recovery

3 & 4: Support and/or Parenting

26:

1: My support system after Drug Court

2: My Story

3 & 4: Support and/or Parenting

#### Phase III

Weeks 1 through 13:

1: Support Group

2: Men's or Women's Group

**DRUG COURT TREATMENT PLAN - PHASE IV**

Phase IV will require a participant to: stay free of drug use and
criminal charges; report to the treatment provider for 1 face to face
counseling sessions per month or as required; report to the case manager
as required; provide urine samples as required; attend AA/NA daily or as
required by the court; appear in court for progress hearings as required
by the court; and the defendant will become involved in being a mentor
for client new to the program. Phase IV participant will also facilitate
the 12 step group at the Treatment Program. This Phase is the aftercare
portion of the program, and it lasts a minimum of six months.