Oasis Addiction Tx Admin Policy by RobZimmerman


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									                                                   OASIS EMPOWERMENT CENTER

                    The Oasis Empowerment Center is an addiction treatment recovery center for women.
                    Established in 2004 as a faith-based outreach of ELIM PACIFIC MINISTRIES, Oasis aims to
                    promote recovery from life-controlling and life-limiting problems due to alcohol and drug use.
                    Our approach is wholistic in nature in that we aim to address the many dimensions of addictive
                    behavior by helping each client explore their recovery process spiritually, physically,
                    psychologically and socially. We use individual and group counseling, education and work
                    therapy to help us build a comprehensive treatment plan that helps each woman develop a life
                    that leads to greater wholeness and freedom from drugs and alcohol.

                    Oasis is not a FREE treatment center but it is supported in part by the Department of Mental
                    Health and strives to provide quality treatment to individuals who want to live a life that is no
                    longer dependant on drugs or alcohol. Basically, our goals are to help achieve the following:
                        to reduce adverse health effects of substance abuse
                        to promote the health of the individual
                        to reduce the risk of transmission of disease

                    Women come to Oasis for different reasons. Some have lost everything because of drugs and
                    alcohol and are homeless or extremely desperate for change. Others are facing jail because of
                    their drug use and may be removed from society if they don’t get treatment. Some are living in
                    situations that make it difficult to maintain sobriety free from drugs or alcohol. We serve others
                    who are required to get treatment because they were arrested for Driving under the Influence
                    DUI. Some drug users are pregnant or gave birth to a baby who tested positive for drug use.
                    Whatever a person’s reason may be, the Oasis can be a place where women can start a new
                    drug-free lifestyle.

                    In order for a client to be admitted to the Oasis treatment program, each individual must apply
                    for services personally. Clients may be referred to the Oasis from other agencies or the courts
                    but the responsibility for completing the steps for admission remain that of the individual
                    seeking addiction treatment services.

                        1. Screening

                    Clients may call the Oasis Empowerment Center or stop by our office for an immediate
                    screening. This will determine client appropriateness for services at Oasis as well as allow
                    individuals to see if the Oasis might be a suitable place for themselves. Oasis is governed by the
                    CHARITABLE CHOICE ACT which states that a client may request a referral to another treatment
                    service provider if they personally do not want to receive services from a faith-based program
                    such as Oasis Empowerment Center.

                    Oasis uses the single page form found on the following page to determine if the priority status
                    and appropriateness of the Oasis to address the needs of the client seeking admission to Oasis.

                                                                 SCREENING FORM

                           Name________________________________________________________           Date_____________________

                           Address ________________________________________________________ Village ___________________

                           Zip _____________ Phone # _________________ Cell # _______________________Work _______________

                           In Case of Emergency Please Call: ______________________________Employer________________________

                           Age: ____ Birthdate _________ Ethnicity ____________________ Referred by:__________________________

                           Last Drug Use______________________Are you attending 12 steps?__________________________________

                           Educational Level ________________ Legal Issues ________________________________________________

                           Current Drug of Choice:     Date of Last Use           Any Special Issues:                Points:
                             Alcohol                             ......            Pregnant injecting drug user          4
                             Prescription Meds____ _________     ......            Pregnant substance abuser             3
                             Crystal Meth                        ......            Injecting drug user                   2
                             Cocaine                             ......            Homeless alcoholic or drug user       2
                             Other Drugs __________________ . . . . . .            HIV +                                 3
                             Detox Services are Needed           ......            My Only way to stay out of Jail       1

                           Why do you want to enter the Oasis Program?

                           If you are homeless, where did you sleep last night?

                           Intake Assessment Appointment:     Date ________________________ Time_______________

                           Oasis Staff Assigned ______________________________________ Priority Rank ___________

                              2. Intake Interview
                           Once the client completes a screening, and it is determined that the Oasis is an appropriate
                           option for treatment, an intake interview must be scheduled with the individual. Ideally, this
                           will happen right away or an intake packet may be provided to the individual to start filling out
                           in anticipation for their intake interview.

                           During the intake interview, our goal is to discover the specific recovery goals that is bringing
                           the client to the Oasis for treatment. We need to really find out what is the level of motivation
                           of the client so that we can match that client with the most appropriate level of care. Research
                           has determined that clients fall into one of 5 different stages of readiness for change. These
                               1. Pre-contemplation
                                   Characterized by the client’s denial that they really have an addiction problem. The goal
                                   of the intervention is to help the client see that they are experiencing problems caused
                                   by the substance use and abuse so that that they become motivated to welcome help to
                                   start to change their life.
                               2. Contemplation
                                   Characterized by an awareness that there are specific problems and circumstances that
                                   need changing but because of ambivalence, are really not ready to take the necessary
                                   steps to start to make changes. The goal here is to be to help identify with the client
                                   what are the specific motivating factors that will energize them to start taking action
                                   towards change.
                               3. Preparation
                                   The client has made a commitment to change and is now seeking help. The goal here is
                                   to work with the client to determine specific treatment goals, and assess the potential
                                   for withdrawal symptoms and what level of care will be best suited for the client.
                               4. Action
                                   When the client is at the action stage of change, they are ready to start working on
                                   recovery need support to begin achieving their goals. They have motivation to start
                                   addressing the issues that contribute to their addiction lifestyle, and to learn how to

                                   establish boundaries. The goal here is to encourage clients as they work on specific
                                   action steps that will lead to greater recovery success.
                               5. Maintenance
                                   Clients who have been through some form of treatment and have established a
                                   recovery plan, need help to strengthen their sober lifestyle to gain greater self-
                                   determination. By expanding accountability and their sobriety network the goal may be
                                   working on some of the deeper issues and traumas that need further healing.
                               6. Relapse
                                   Clients who have stopped following a recovery plan need to be assisted to see where
                                   relapse occurred, to determine what worked and what did not work in their life before
                                   and to build a more effective recovery plan that will lead to sobriety.

                              3. Assessment
                           A comprehensive questionnaire is used to get a full background history of drug and alcohol use,
                           medical history and other details needed to determine the appropriate level of care and begin
                           making a treatment plan with individual.

                           If it is determined that the client is in the Pre-Contemplation stage, then it may be better to
                           simply determine why the client was referred to the Oasis and focus during on what they hope
                           to will be changed by receiving services at the Oasis. If they client had a DUI judgment, then
                           education about addiction, consequences of drug use, Guam laws, and life opportunities may
                           be all that the client will participate with. Clients whose only problem is homelessness is better
                           served at a shelter such as Guma San Jose. The MAST assessment may be more useful here to
                           help the client to realize that really have a problem that needs to change. Seeing a score of 3
                           out of 7 will help the client see objectively that they do have a problem.
                                  Demographic Information
                                  MAST
                                  Legal Problems
                                  Work History and Income Potential

                           Clients at the contemplation stage will be served best by helping the client see what could
                           change if they started planning for recovery. Help clients to see how their life could be different
                           will motivate them to start setting some recovery goals. Also help them discover that change
                           will not happen if they don’t start working toward that goal. Oasis staff need to focus on
                           Motivational Interviewing to overcome ambivalence and move them to the Preparation Stage.
                                Drug or Alcohol Abuse History and their individual Behavior Patterns
                                Recovery Environment
                                Their Family network and who were abusers or addicts in their life
                                Homeless Evaluation

                           Clients at the Preparation Stage will be best served by a thorough assessment to determine
                           specific treatment goals that can be set to work on. We focus on looking at the life as a whole:

                                Physical Issues, including medical concerns, STD’s and withdrawal potential
                                Sexual Activity in relation to drug use
                                Determine who will be part of this client’s sobriety network
                                Spiritual History

                           As the assessment is completed for each client at their individual stage of change a schedule of
                           classes, and counseling interventions can be offered for the client to decide if they will commit
                           to that recommended course of treatment for them.

                           Ultimately a signed commitment to the recommended treatment plan will be the final result.

                                 Answer these questions with regard to your use of alcohol, drugs or prescription medication.

                           YES   NO

                                            Have you used drugs other than those required or prescribed for medical reasons?

                                            Do you take prescription drugs whenever you want rather than on a recommended
                                            schedule or dosage?

                                            Do you abuse more than one drug at a time?

                                            I Can’t really get through the week without using drugs or alcohol?

                                            Have you had "blackouts" or "flashbacks" as a result of drug or alcohol use?

                                            I am not always able to stop using drugs when you want to?

                                            I need to drink some alcohol to steady my hands.

                                            Do you ever feel bad or guilty about your drug use?

                                            Does your spouse (or parents) ever complain about your involvement with drugs or

                                            Has drug abuse created problems between you and your spouse or your parents?

                                            Have you lost friends because of your use of drugs?

                                            Have you neglected your family because of your use of drugs?

                                            Have you been in trouble at work because of your use of drugs?

                                            Have you lost a job because of drug or alcohol abuse?

                                            Have you gotten into fights when under the influence of drugs or alcohol?

                                            Have you engaged in illegal activities in order to obtain drugs?

                                            Have you been arrested for possession of illegal drugs or driving under the influence?

                                            Have you ever experienced withdrawal symptoms (felt sick or had the shakes) when you

                                            stopped taking drugs or drinking alcohol?

                                            Have you had medical problems as a result of your drug use (e.g., memory loss,
                                            hepatitis, convulsions, bleeding, etc.)?

                                            Have you gone to anyone for help for a drug problem?

                                            Have you been involved in a treatment program especially related to drug use?

                                            Totals (21 questions)

                                                   OASIS EMPOWERMENT CENTER

                    The Oasis has several different levels of care available for women seeking addiction treatment.
                          i. Basic Introduction to Recovery Services ASAM 0.5 (5 Clients)
                             This is for women who may have been arrested for a DUI and need to complete 20
                             hours of drug education classes. This program is currently offered on Tuesday
                             afternoons from 2-5 PM)
                         ii. Outpatient Addiction Treatment ASAM Level 1.0 (5 Clients)
                             This is one of our most flexible levels of care. It is not intensive treatment and is
                             completed when the client completes 34 hours of individual and group counseling.
                             This is provided in the afternoons and some evenings at Oasis along with some
                             individual sessions that are scheduled by appointment. This program is currently
                             offered on Tuesdays, Wednesdays and Thursday afternoons, from 2PM to 5 PM
                        iii. Intensive Outpatient Addiction Treatment - ASAM Level 2.0 (Limited to 5 clients)
                             This is for clients needing more intensive treatment, from 9 to 20 hours of contact
                             hours each week for a total of 64 hours total work on developing a recovery oriented
                        iv. Residential Services – ASAM LEVEL 3.5 (Limited to 8 clients at a time)
                             For individuals who don’t have a clean and sober home environment or don’t have the
                             support systems available to establish a recovery oriented lifestyle, this residential
                             level of care provides the necessary structure a client may need to effectively start
                             living free from drugs or alcohol. This is a therapeutic community setting in a group
                             home environment with strict rules and guidelines. There are only a limited number of
                             spaces available for this level of care and clients may be eligible to stay in this level of
                             care for up to 6 months.
                         v. Social-Detox Services ASAM LEVEL 3.2-D (Limited to 2 Clients at a time)
                             For the first two weeks of residential or intensive treatment each client will be
                             required to be part of a Social Detoxification Program where your vital signs are
                             monitored during the withdrawal phase of your treatment. Clients will be assigned a

                             bed in the back room of HOUSE 1 during this level of care.

                    After the intake assessment is completed, the client should be able to begin their treatment
                    within 48 hours. No admissions are done on the weekend so clients needing emergency
                    treatment services should go to the Guam Memorial Hospital or admit themselves to the Adult
                    Inpatient Unit at the Department of Mental Health and Substance Abuse.

                    As the client progresses through treatment, and goals are achieved, treatment plans may be
                    modified and clients are able to transition to a decreased level of care or program intensity.

                              4. Wait-Lists and Priority Placements
                           Because of program limitations, Oasis may have to prioritize client admissions. After a face-to-
                           face intake assessment, placement options will be discussed. Pregnant women are given
                           priority in treatment at the Oasis. The following criteria are used for prioritizing client intakes:
                                        1. Pregnant injecting drug users
                                        2. Pregnant substance abusers
                                        3. Injecting drug users (Maximum wait time is 14 days)
                                        4. Homeless alcoholics or drug users
                                        5. All others

                           Due to health regulations, each residential client must have a current PPD Test to ensure they
                           are not carriers of Tuberculosis. They may also be required to obtain other medical clearances
                           prior to admission into the residential program.

                           Clients are encouraged to be admitted for treatment within 48 hours after completing their
                           intake assessment. Even when there are no available bed-spaces for clients seeking residential
                           treatment, a client may be admitted for out-patient services immediately upon completion of
                           their initial treatment plan.

                           If a client chooses to be listed on the Oasis waiting list rather than begin their treatment,
                           please note that that waiting list is only maintained active for 30 days. Individuals in treatment,
                           but waiting for the appropriate level of service, will be counted as waiting for the appropriate
                           level of service. For example, a woman receiving one hour of outpatient treatment once a
                           week while waiting to enter a residential program will be counted as waiting for residential

                           Clients seeking treatment who are on the wait-list must be responsible to update their status at
                           least every 30 days or they will be removed from the wait-list.

                              5. Legal Issues
                           As an addiction treatment center, Oasis Empowerment Center is not an alternative to Jail.
                           Clients are encouraged to complete their legal requirements first and commence treatment as
                           soon as possible upon completion of any court order. An emergency admission of the Oasis
                           will not necessarily help a client avoid going to Jail. Caseworkers are able to help the client
                           convert any fines to community service hours that can be completed at Oasis while the client is
                           in treatment.

                              6. Confidentiality
                           In a group setting such as Oasis, each client must commit to confidentiality of the information
                           of each person in the program. Any client who violates this policy may be terminated from the
                           program in order to ensure the safety and trust of the therapeutic community setting.

                           No client or staff is allowed to give any information about a client in the Oasis program without
                           the expressed written permission. Clients will be asked to sign a waiver of this confidentiality so
                           case-management work can be facilitated on the clients behalf while in the program. Each
                           client’s case files will be maintained safe and secure at the Oasis even after a client’s their
                           treatment is completed.

                           When a client’s case is closed, the waiver of confidentiality is also revoked. The only way any
                           staff person can discuss a client’s case is if the courts subpoena our office. The only thing that
                           can be discussed even in that situation is when the client was in treatment and if they
                           successfully completed treatment by accomplishing their treatment plan contract. If a client did
                           not complete treatment, or withdrew, or did not show up, we may also inform the courts of
                           that incomplete outcome.

                             7. Orientation
                           Upon admission, clients will be given a recovery manual that will provide orientation material, a
                           weekly schedule and helpful information to help make your recovery program successful. We
                           want each client to know what they can expect in treatment, and how the process works to
                           move through the different phases of the program.

                              8. Random Drug Screening
                           Each client in the Oasis Recovery program will also be required to submit to random drug
                           screenings or urinalysis while actively in the Oasis program. This must be observed by our

                           female staff in the rest-room to monitor the fidelity of the test and ensure that the test is not

                               9. Rides and Transportation
                           The Oasis does not make any promises to provide rides to clients in treatment. If transportation
                           is an obstacle to treatment, then with the intake worker, a mobility or transportation plan must
                           be developed for the client. Another option is to request home-based treatment. This can be
                           discussed with a recovery counselor.

                              10. Completing the Program
                           The level of care, and the treatment plan objectives determines when the client will officially
                           complete and commence the Oasis program. Each level of care has a certain number of
                           minimum contact hours required. What actually guides the treatment for each client is their
                           individual treatment plan. This plan is developed at intake and then modified though the
                           treatment process as individualized goals are achieved and milestones are reached.

                              11. Exiting the Program
                           Clients attend the Oasis Empowerment Center as free individuals. The residential program of
                           the Oasis is not run as a jail so clients are able to leave treatment on their own and withdraw
                           themselves from the program when-ever they choose. A client who refuses treatment and
                           violates policy will be discharged from the program and restricted from re-admission for a
                           period of up to 6 months. Depending on how the client leaves the Oasis program, will
                           determine if the client may apply for readmission at a later date.

                              12. Ease of Entry
                           The Oasis strives to make admission as easy a process as possible. There is a lot of information
                           required to get a full understanding of the nature of the addiction and develop a strategy to
                           provide treatment effectively. We also aim to minimize delays in getting into treatment, but
                           each client must be responsible to meet the various eligibility requirements for services.

                              13. Discrimination Policy
                           The Oasis Empowerment Center is a faith-based outreach of Elim Pacific Ministries but it does
                           not discriminate with regard to whom services are provided to based on race, religion, religious
                           belief, or sexual orientation nor refusal to participate in a religious practice. Each individual is
                           respected and treated with human dignity.

                           The Oasis follows guidelines of the Charitable Choice Act. If individuals object to the religious

                           character of this organization, Federal Law gives individuals a right to a referral to another
                           provider of services, specifically substance abuse treatment services. The referral and a clients
                           receipt of alternative services, must occur within a reasonable period of time after they are
                           requested or applied for. The alternative provider must be accessible to the client as well as
                           have the capacity to provide the specific substance abuse services. The services provided must
                           be of a value not less than the value of the services a client would receive at this organization.

                               14. Grievance Policy
                           All Clients, employee or citizen has the right to file any concerns, complaint or grievance with
                           our receptionist, who will direct this to our current chairman of the board to be addressed.


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