Private Organization Accreditation

White's Residential & Family Services is Indiana's largest social services agency offering accredited and comprehensive residential, foster care, independent living, adoption, and home-based services.


Barry Gourley

Volunteer Roles: Endorser; Peer Reviewer

It is an honor to be a COA volunteer. I’ve had a great opportunity to work with fabulous COA volunteers, I’ve grown professionally in the COA accreditation process and I’ve met some wonderful people across this nation who are working hard to help and support children and families.
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Individuals who participate in Opioid Treatment Programs improve social, emotional, and vocational functioning, achieve optimal productivity, and attain the recovery they seek.

PA-OTP 9: Toxicology Testing for Continued Drug Use

Toxicology testing is an integral component of service planning and clinical practice to help monitor and evaluate the individual’s progress in treatment.

Rating Indicators
Full Implementation, Outstanding Performance
A rating of (1) indicates that the agency's practices fully meet the standard and reflect a high level of capacity.  
  • All elements or requirements outlined in the standard are evident in practice, with rare or no exceptions; exceptions do not impact service quality or agency performance. 
Substantial Implementation, Good Performance
A rating of (2) indicates that an agency's infrastructure and practices are basically sound but there is room for improvement. 
  • The majority of the standards requirements have been met and the basic framework required by the standard has been implemented.  
  • Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality or agency performance.  
Partial Implementation, Concerning Performance
A rating of (3) indicates that the agency's observed infrastructure and/or practices require significant improvement.  
  • The agency has not implemented the basic framework of the standard but instead has in place only part of this framework.   
  • Omissions or exceptions to the practices outlined in the standard occur regularly, or practices are implemented in a cursory or haphazard manner. 
  • Service quality or agency functioning may be compromised.   
  • Capacity is at a basic level.
Unsatisfactory Implementation or Performance
A rating of (4) indicates that implementation of the standard is minimal or there is no evidence of implementation at all.  
  • The agency’s observed service delivery infrastructure and practices are weak or non-existent; or show signs of neglect, stagnation, or deterioration.  
Please see Rating Guidance for additional rating examples. 

Table of Evidence

Self-Study Evidence On-Site Evidence On-Site Activities
    • Policies and procedures related to toxicology testing and record keeping
    • Medical protocols
No On-Site Evidence
    • Interview:
      1. Medical personnel
      2. Relevant personnel
      3. Individual responsible for ensuring compliance with regulations regarding toxicology reports
      4. Persons served
    • Review case records

  • PA-OTP 9.01

    Prior to establishing a contract, the agency evaluates the quality of the laboratory to perform drug screens, including use of equipment, methodology, and quality control.

  • PA-OTP 9.02

    Toxicology specimens are obtained:

    1. with respect for individual privacy;
    2. in a safe treatment atmosphere;
    3. randomly; and
    4. in a manner that minimizes the possibility of falsification.

    Interpretation:Toxicology specimens are obtained randomly based on protocols established in PA-OTP 9.03.

    Interpretation: Drug testing regimes are determined based on individual assessment results and by analyzing community drug-use patterns. Testing may include, but not be limited to, opiates, benzodiazepines, barbiturates, cocaine, marijuana, methadone (and its metabolites), amphetamines, and alcohol.

  • PA-OTP 9.03

    After the individual’s initial admission test, the timing and frequency of toxicology testing is clinically appropriate for each individual, and the opioid treatment program conducts:

    1. at least eight random drug tests per service recipient, per year;
    2. at least one initial and two subsequent tests for individuals in interim maintenance treatment; and
    3. tests, as appropriate, during medically supervised and other types of withdrawal.

  • PA-OTP 9.04

    Toxicology testing practices include, and are not limited to:

    1. informing individuals about how specimens are collected and of their responsibility to provide a specimen when asked;
    2. discussing positive toxicology results with the individual;
    3. providing counseling, medical review, and other interventions if the person continues to test positive for illegal substance use;
    4. methods to minimize falsification during the drug testing sample collection;
    5. a process for reviewing false-positive and false-negative results; and
    6. documenting results in the case record along with the person’s response.

    Interpretation: Immediate action is taken to investigate possible diversion of opioid medication when toxicology tests indicate lack of opioids or related metabolites.

  • PA-OTP 9.05

    Following the receipt of toxicology test results, the agency:

    1. evaluates negative reports for opioid treatment medication and related metabolites;
    2. reviews dosage when positive toxicology reports for drugs are received;
    3. investigates the possibility of false positive results when individuals deny drug use;
    4. rapidly responds if the individual is found to be in danger of relapse; and
    5. uses the results to determine the need for additional interventions.

    Interpretation: Immediate action is taken to investigate possible diversion of opioid medication when toxicology tests indicate lack of opioids or related metabolites.

  • FP
    PA-OTP 9.06

    Evidence of ongoing drug use is not considered grounds for discharge, unless the individual refuses to cooperate with treatment recommendations.

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