D-Met And Her Aruba Trips: A Case Study

3. The patient had informed this writer initially of his goals of wanting to return back to the Hartford Dispensary due to the length of time he has been with the clinic and his positive rapport with his prior counselor at the other facility. The patient was compliant with his individual sessions with this writer and provided cancellation if unable to attend the session in the meantime while he awaits on the process of completion with his intake at Hartford Dispensary.

D-This writer met with the patient as he was placed on HOLD to address the status of the IOP. The patient provided this writer a paper that was provided to him with listing of IOP for him to explore. The paper shows scribbles of the patient taking down notes about his attempts of who he called. The patient reports Connecticut Addiction Recovery will call him back within 24-48 hours. The patient was able to schedule an appointment with New Direction for May 20th at 7pm; patient spoke with Dan. This writer commends the patient for all of his efforts; however, the patient needs to schedule something earlier than May 20th. This writer asked the patient about ICRC-Coventry House. According to the patient, he called the contact number and showed proof. The patient reports that ICRC gave him two different number and told him to do a walk-in at 8:30am. This writer shared with the patient about a recent conversation this writer had with ICRC. This writer told the patient

He reports the patient’s roommate was subsequently evicted from his home after the landlord inquired about the ambulance visiting. He reports he contacted her father concerning the patient residing within the family home, but the father has said no. In addition, he reports he has attempted to contact her uncle but has been unable to make contact with him. He reports he has attempted to make contact with her said friend who is considering allowing her the opportunity to reside with her but she has not answered her phone and he has been unable to leave a voice message. He reports no one wants her in their home, and the patient has “burned her bridges” with family members. He reports her family would benefit from counseling. In addition, he reports her family has high expectations of CPS. He reports her current case was not going to close within 12 days of 06/30/2017. In addition, the case will not

D-The patient arrived on time for her session. Reports stable on her dose. This writer discussed about tapering off on her methadone, at which the patient is willing to consider doing, but needs more time. She then says, " I might consider doing it next month, but not right now......I was doing it before, but it stopped....just want to take my time." The patient then discussed about having to go to SSA to obtain the payment for the funeral cost. The patient is upset about the small amount she is about to receive. This writer discussed the grieving process of her loss of her husband and also, her mother in law. The patient appeared to be annoyed with her son for not participating in his grandmother funeral arrangement and also, not showing

On 3/29/2017, this writer met with Mary Eckola alongside with Adriana upon request in the event that the patient assigned counselor is not available. During the discussion, it was based on addressing the overpayment of the patient and her significant other. Also, HCRC continues to send the patients medical record to the insurance company, but no payment. Adriana discussed about payment options, referring to an 8 week payment plan for Mary and her significant other as Mary appeared to the receptive the notion of the payment plan. Mary was very forthcoming about paying the entire balance of her balance and her significant other, but wants to be certain that should be pay the balance that there will be no other issue with this matter. According

D-Met with the patient to address a fax from DCF request of the patient records. The patient immediately said, " Don't send this shit. I cannot stand that worker.....I was in court the other day and I am tired of this and this worker always in my business." The writer explained to the patient that should he continue to refuse to sign an ROI, it may hurt his reunification with his son as the patient detailed to this writer about how DCF got involved in his life ( According to the patient, he was intoxicated when visiting his son and a case was called against him and the child's mother). The patient made it clear to the writer that he has no desires to signed an ROI for DCF and for the clinic to ignore DCF request.

D-Spoke with the patient as she was being curbside dose. This writer reiterate about TEAM recommendation, at which the patient declines the notion of being placed in a skilled nursing facility due to her medical issues.This writer informed the patient that her level of care is inappropriate for this treatment and a high level of care would be more efficient. According to the patient, she's working with Chrysalis and is willing to sign an ROI for this writer to communicate with her case worker Anthony, aka Tony. Reported stable on her dose.

The patient arrived on for his counseling session. Reports stability on his current dose and denies the need for a dose increase or decrease when offered by the writer. The patient was made aware that he will be reassigned to counselor, Scott effectively immediately as his new assigned counselor will schedule his next session. The patient reports of no update with his medical pertaining to a referral to another PCP as he is currently still seeing the same medical provider.

D-This writer agreed to meet with the patient as he was placed hold to attend group. Reported stability on his current dose and denies the need for a dose increase when offered by this writer. This writer reviewed the patient's record and learned that he obtained his 3rd take home bottle on 01/04/2017. The patient is aware that he in order for him to obtained the 4th take home bottle, he must attend the take home bottle group. Addressing his medication, this writer noticed that the patient has not refilled the following medications:

RMHU: Evesole, no problems, spoke to him briefly, was waiting for medical to disburse his medication. Evesole also went out to the recreation yard for fresh air for about 10 minutes. Mr. Evesole also is requesting to attend church, I have not given him an answer as of yet, wasn’t sure if he could. I’m adding that Mr. Evesole has been very cooperative today with appropriate behaviors and verbal discussions, with staff and clinical. Alexander, V. wrote order for him to stay on Constant Observation due to masturbating the night before also a code was called. I spoke to him and

Supervisor Comments: This writer met with Cherron to address services due by counselor and reminded the Cherron about submitting his services by staff by day every week on Friday, of which Cherron have been doing. Cherron is still behind on his treatment; however, he was able to update this writer about the status of where he is with getting current with his work. Based on the services due provided from Cherron, Cherron is in need of 5 patient signatures and few was already submitted to the Clinical Director, but pending. This writer offered to help Cherron if he is in need to obtained the patient signature.

The patient expressed about feeling that she is self-sabatoge her recovery for no apparent reason and currently thinking about going into an inpatient treatment- more so, a treatment that is spiritual. The patient shared that lately she's been feeling down and haven't been to going to church for the past two weeks. In addition, the patient shared about having homocidial thoughts with regards to her daughter's DCF case as she expressed frustration with the custody battle. This writer advises the patient about this writer's role as a mandated reporter and based on the patient comment of having homocidal thoughts, she recanted her statement and says," So, you are telling me that I cannot vent and express how I feel.....I am going to keep my mouth

D-Met with the patient upon request. Upon meeting with the patient, the patient appeared upset and addressed her frustration in this writer's office. According to the patient, she's upset with her PCP forcing the patient to admit herself to the psych. ward to get on medication. Failure to do so, her PCP will complete the medication protection for her electricity. The patient owes over $3000 and with the protection, her light company cannot turn off her lights. Please note, the patient was pacing back and forth and getting emotional. This writer consolet he patient and validated her feelings. According to the patient, she reports that CMHA informed her that she in order to get into their clinic, an evaluation is needed whereas the evaluation can be completed at a hospital; however, the patient is worried about being admitted. Please note, the patient denies any suicidal or homocidal ideation when questioned.

We were standing in the airport in Aruba, and at that moment I had no idea how we got into that mess. Our clothes were drenched; each one of our faces exhibited emotional distress.

Counselor flagged Pt. on the AMS computer system to meet with this writer before dosing. Pt. met with counselor discussed and completed an AMS Dose evaluation to increase her dosage of methadone because she isn’t feeling well and experiencing side effects. Counselor prompted Pt. to talk about her pregnancy, medical appointment and to schedule her monthly therapy session with this writer. Pt. reported that her pregnancy is going well and she is having a lot of appointments at the Bay health hospital in Dover, DE. Pt. stated that they can’t determine the baby sex because her baby has the legs cross. Counselor told pt. that the Bay Health Hospital has a good nicu care unit and professional doctors. Counselor asked Pt.is