WHO IS ACCREDITED?

Private Organization Accreditation

Debt Education and Certification Foundation (DECAF), a private non-profit 501(c)(3) organization, provides high-quality financial education and counseling, with nationwide outreach throughout the U.S. DECAF is HUD-approved, and recognized as one of the 100 Best Companies to Work for in Texas.
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VOLUNTEER TESTIMONIAL

Ulysses Arteaga, L.C.S.W.

Volunteer Roles: Commissioner; EPPA; Marine Reviewer; Military Reviewer; Peer Reviewer; Team Leader

The Consuelo Foundation 2012 Peer Reviewer of the Year, Mr. Arteaga conducts two to three site visits a year, often volunteering for visits that require a Spanish speaking peer.
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Purpose

Individuals who participate in Opioid Treatment Programs improve social, emotional, and vocational functioning, achieve optimal productivity, and attain the recovery they seek.

CA-OTP 11: Dosage Requirements

The organization follows procedures for administration of opioid treatment medication to ensure that an adequate, individually determined dose is dispensed.

Rating Indicators
1
All elements or requirements outlined in the standard are evident in practice, as indicated by full implementation of the practices outlined in the Practice standards.
2
Practices are basically sound but there is room for improvement, as noted in the ratings for the Practice standards; e.g.,
  • Minor inconsistencies and not yet fully developed practices are noted, however, these do not significantly impact service quality; or
  • Procedures need strengthening; or
  • With few exceptions procedures are understood by staff and are being used; or
  • For the most part, established timeframes are met; or
  • Proper documentation is the norm and any issues with individual staff members are being addressed through performance evaluations (CA-HR 6.02) and training (CA-TS 2.03); or
  • Active client participation occurs to a considerable extent.
3
Practice requires significant improvement, as noted in the ratings for the Practice standards. Service quality or program functioning may be compromised; e.g.,
  • Procedures and/or case record documentation need significant strengthening; or
  • Procedures are not well-understood or used appropriately; or
  • Timeframes are often missed; or
  • A number of client records are missing important information  or
  • Client participation is inconsistent; or
  • One of the Fundamental Practice Standards received a rating of 3 or 4.
4
Implementation of the standard is minimal or there is no evidence of implementation at all, as noted in the ratings for the Practice standards; e.g.,
  • No written procedures, or procedures are clearly inadequate or not being used; or
  • Documentation is routinely incomplete and/or missing; or  
  • Two or more Fundamental Practice Standards received a rating of 3 or 4.

Table of Evidence

Self-Study Evidence On-Site Evidence On-Site Activities
    • Procedure for dosing and administration of opioid treatment medication that address weekend, holiday, travel, and after-hours administration
No On-Site Evidence
    • Interview:
      1. Medical director
      2. Relevant personnel
      3. Persons served
    • Review case records

  • FP
    CA-OTP 11.01

    Opioid treatment medication is administered as follows:

    1. a physician makes all dosage decisions within the medically accepted dosage range for effective treatment;
    2. conditions for use are documented in the person’s case record;
    3. medications are administered and dispensed in accordance with approved product labelling;
    4. the initial dose of methadone does not exceed 30 milligrams, and 40 milligrams as a total dose for the first day; and
    5. methadone is dispensed in oral form.

    Interpretation: The initial dose of methadone must be determined by an OTP physician familiar with the most up-to-date product labelling, who considers factors, such as body weight, size, other substance-use and abuse, diet, co-occurring disorders, medical diseases, genetic factors, and tolerance. Although the initial dose is indicated not to exceed 30 milligrams, this dose is not appropriate for everyone, and some individuals may require much lower doses. All individuals should be closely monitored during the induction phase and the increases in dosage should be under the close supervision of the physician. It must be documented in the case record when the 40 milligrams total dose is exceeded based on the physician’s determination that the previous dosage did not suppress the person’s withdrawal symptoms.

    Note: Elements (d) and (e) do not apply to medications other than methadone. 


  • FP
    CA-OTP 11.02

    When a physician determines a person is eligible to receive take-home medication, the dose is limited to no more than:

    1. one dose per week in the first 90 days of treatment;
    2. two doses per week in the second 90 days of treatment;
    3. three doses per week in the third 90 days of treatment;
    4. a six-day supply in the remaining months of the year;
    5. a two-week supply after one year of continuous treatment; and
    6. a one-month supply after two years of continuous treatment.

  • FP
    CA-OTP 11.03

    Service recipients receive the appropriate dosage of opioid treatment medication for days when the clinic is closed, for weekends, holidays, and travel.

    Interpretation: The organization informs individuals of its plan for administration of medication in the event that the programits temporarily closed due to an emergency.

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