Standards for private organizations

2020 Edition

Opioid Treatment (OTP) 4: Intake and Assessment

The organization's intake and assessment practices ensure that individuals receive prompt and responsive access to appropriate services.
2020 Edition

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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.
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.
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
  • In a few rare instances, urgent needs were not prioritized; or
  • For the most part, established timeframes are met; or
  • Culturally responsive assessments are the norm and any issues with individual staff members are being addressed through performance evaluations and training; or
  • Active client participation occurs to a considerable extent.
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
  • Urgent needs are often not prioritized; or 
  • Services are frequently not initiated in a timely manner; or
  • Applicants are not receiving referrals, as appropriate; or 
  • Assessment and reassessment timeframes are often missed; or
  • Assessments are sometimes not sufficiently individualized; 
  • Culturally responsive assessments are not the norm, and this is not being addressed in supervision or training; or
  • Several client records are missing important information; or
  • Client participation is inconsistent; or
  • Intake or assessment is done by another organization or referral source and no documentation and/or summary of required information is present in case record. 
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.,
  • There are no written procedures, or procedures are clearly inadequate or not being used; or
  • Documentation is routinely incomplete and/or missing.  
Self-Study EvidenceOn-Site EvidenceOn-Site Activities
  • Screening and intake procedures
  • Assessment procedures
  • Copy of assessment tool(s)
  • Community resource and referral list
  • Interviews may include:
    1. Program director
    2. Relevant personnel
    3. Persons served
  • Review case records


OTP 4.01

Individuals are screened and informed about:
  1. how well their request matches the organization's services; and
  2. what services will be available and when.
NA Another organization is responsible for screening, as defined in a contract.

Fundamental Practice

OTP 4.02

Prompt, responsive intake practices:
  1. gather information necessary to identify critical service needs and/or determine when a more intensive service is necessary;
  2. give priority to pregnant women, and individuals with urgent needs and emergency medical or psychiatric situations;
  3. facilitate the identification of individuals and families with co-occurring conditions and multiple needs;
  4. support timely initiation of services; and
  5. provide placement on a waiting list or referral to appropriate resources when individuals cannot be served or cannot be served promptly.


OTP 4.03

Persons served participate in an individualized, culturally and linguistically responsive assessment that is:
  1. completed within established timeframes;  
  2. updated as needed based on the needs of persons served; and
  3. focused on information pertinent for meeting service requests and objectives.


The Assessment Matrix - Private, Public, Canadian, Network determines which level of assessment is required for COA’s Service Sections. The assessment elements of the Matrix can be tailored according to the needs of specific individuals or service design.

Fundamental Practice

OTP 4.04

Each person admitted to the program receives a medical evaluation by a physician, or a qualified medical practitioner under the supervision of the medical director, within 14 days of admission that includes, but is not limited to, the following baseline information:
  1. medical history, including history of narcotic dependence;
  2. evidence of current physical dependence;
  3. laboratory examinations, including a serological test for syphilis, a tuberculin skin test, and a toxicology test to analyze drug dependence;
  4. determination of the presence of infectious diseases or organ abnormalities;
  5. determination of vital signs, general appearance, and condition; and
  6. family, economic, occupational, and housing needs.

Fundamental Practice

OTP 4.05

Persons served are screened for:
  1. high-risk behaviors related to HIV/AIDS, sexually transmitted diseases, multi drug-resistant tuberculosis, and other infectious diseases;
  2. patterns of other drug use, including Benzodiazepines;
  3. presence of co-occurring health and mental health conditions; and
  4. issues related to criminal activities.


Individuals known to use Benzodiazepines, even when prescribed, should be counseled as to their risk and provided with overdose prevention education and medication to counter the effects in the event of opioid overdose.


Individuals identified as having mental health needs should receive integrated treatment directly or through referral to a cooperating service provider.