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1. Determine who in the agency will conduct the screening. The county DSS has the responsibility to conduct the substance abuse screening. However, a county DSS and the Local Management Entity may, via an agreement, decide that a QPSA or other qualified person or agency, assigned by the Local Management Entity, conduct these screenings.
2. The substance abuse screening is an integral part of the application process for applicants. If the applicant fails or refuses to be screened, deny the application for cash assistance and evaluate for Medicaid. Screening must be done at the following times:
• Before the application is processed; and/or
• At any other time considered appropriate.
On-going recipients who refuse or fail to be screened lose eligibility for cash assistance and must be evaluated for a transfer to Medicaid.
NOTE: The screening requirement does not apply to the payee in a child-only case. If an applicant/recipient is currently receiving substance abuse treatment, the screening requirement is not necessary. However, it is necessary to verify that the applicant/recipient is currently in substance abuse treatment. To verify participation in a substance abuse treatment program, ensure that the consent form is completed as instructed in #3 below. Obtain written documentation from the treatment provider that the individual is participating in a treatment program. File this information in the case record. If the information can not be verified prior to the disposition of the application or completion of the review (if appropriate), then the AUDIT and DAST-10 must be completed. If the applicant/ recipient refuse to sign the consent form, then the Audit and DAST-10 must be completed. Applicant/recipient statement is not acceptable as verification.
3. Ensure that the consent form, DSS-8219, is completed and signed. This will allow the QPSA to provide the results of the applicants/recipients assessment and progress with the treatment plan, if appropriate. Provide a copy of the signed consent form and the screening results (if appropriate) to the QPSA.
4. File the screening tools in the DSS case record, and document the date of the assessment appointment.
A combination of two screening tools, AUDIT and DAST-10, have been adopted. They are designed to be used together to screen for alcohol and drug abuse. Complete these screening tools, DSS-8218 for each adult Work First applicant/recipient. The scoring instructions are on the back of the form. (See Figure 104B-1 for wording that may be used when introducing the questions in the AUDIT and DAST-10.)
If an applicant/recipient meets or exceeds the scoring criteria for a positive screen (a score of 8 or more) on the AUDIT and/or the moderate level for the DAST-10, refer the adult to the QPSA following procedures developed in the county. Write on the Mutual Responsibility Agreement (MRA) Plan of Action that the applicant/recipient must keep the scheduled appointment with the QPSA.
If the DAST-10 score is at the level where the recommendation is “reassess at a later date,” screen the individual within 90 days unless a referral has already been made to a QPSA based on behavioural indicators.
NOTE: Counties are prohibited from drug and alcohol testing such as hair test, blood test, saliva test, and breathalyzer or urine tests as a screening tool for Substance Abuse for Work First applicants or participants. However, if an individual is participating in Work Experience, the sites’ employer may request the individual to complete a drug and alcohol toxicology screen.
Regardless of whether the applicant/recipient screens positive on the AUDIT and DAST-10, if behavioural indicators are present, refer the adult to a QPSA. (“Substance Abuse Behavioural Indicator Checklist”, DSS-5325 to document behavioural indicators based on which a referral to the QPSA is made.) Have the applicant/recipient sign the Consent for Release of Confidentiality Information Form at that time.
When behavioural indicators are used to make a referral to a QPSA, explain to the applicant/recipient the reason the referral is being made. Workers may use the wording suggested on Figure 1.
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For questions or clarification on any of the policy contained in these manuals, please contact your local county office. |
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