1. U.S. Probation/Pretrial Treatment Service Providers Training
12/17/09

2. Referral Process

3. Procedure and Documents
USPO/USPSO calls to schedule initial intake appointment for offender/defendant
USPO/USPSO forwards:
Program Plan
Aftercare Case Summary
Release of Confidential Information Form

4. Program Plan
Review to program plan to ensure all necessary codes are included
Have offender sign
Send original back to officer and retain copy in your file

5. Program Plan
Do not provide services not listed on the Program Plan, you will not be paid
Initial intake can be billed as 2 units of 2010
If transfer from one vendor to another, 1 unit of 2010 can be billed if authorized by USPO in “Instruction Section”

7. Release of Information Form
Ensure form is filled out completely
Offender/defendant signs
Witness signs
Original is returned to USPO/USPSO
Copy retained in your file

8. Urine Specimen Collection Procedures

9. UA Collection
Although the Statement of Work establishes guidelines for unobserved urine collections, this method is highly discouraged by the U. S. Probation Office.
•Never underestimate what an addict will do to conceal drug use or try to “beat” the drug test.
•Temperature strips must be available for unobserved urine collections

10. Call in Procedures Use a code-a-phone/message recorder system
Update message daily
Do not give more than 12 hours notice

11. Requirements Testing must occur 7 days a week including holidays
Offenders/defendants must be tested at least one weekend per month
Back-to-back testing (two consecutive days) must occur monthly for Phase I
Collection of urine specimens should be observed
One unobserved specimen collection is allowed per month, if absolutely necessary

12. Daily Treatment Log
Offender/defendant signs in and out for each service
Each service must be listed on a separate line (i.e counseling and testing)
Vendor also signs each entry
Forward DTR with invoices monthly

13. Urine Collection-Step 1
The subject should be escorted from the waiting area to the collection area by the collector.
Be cognizant of body language and potential efforts to conceal a “cheating” device.
The collector and the subject are the only people present in the collection area at this time. Multiple collections should not occur at the same time.

14. Urine Collection –Step 2
The collector shall obtain supplies from a secured area in view of the subject.
Chain of Custody (COC) form
Specimen ID labels
Red tamper evident seal
Specimen bottle
Wide-mouthed cup
Tamper evident bag

15. Urine Collection –Step 3
The collector fills out the top portion of the COC form (subject’s name, PACTS number, supervising officer, collection date/time, and medications).
Verify information on pre-printed forms.

16. Collectors shall: Use a clinical refractometer on all specimens
Ensure specific gravity (s.g.) is or higher
If s.g. is lower, allow 1 hour to collect another sample at no charge
Ensure sample is a minimum of 35 milliliters
Permit no more than 2 hours to provide a valid sample if stall occurs

17. Collectors shall (con’t):
Use Non-Instrumented Testing Devices (onsite) for all testing
Allow 15 minute grace period before reporting a “no show” (until 9:15 am)
Collect urine between the hours of 5:00 am-9:00 am only
Do not allow waiting period to exceed 15 minutes

18. Collectors shall (con’t):
Do not disclose the schedules of testing or number of tests to offenders- defendants
Do not share personal work schedules
Meet monthly with officers in person or via telephone
Be available by phone, cell phone and/or

19. Urine Collection –Step 4
The subject signs a specimen ID label.
The subject affixes the signed specimen ID label to the bottle, and affixes the matching specimen ID label to the COC form.

20. Urine Collection-Step 5
The collector maintains control of all supplies and escorts the subject into the testing room.
Ask the subject to remove any bulky (concealing) clothing, and to roll up sleeves so that wrists/forearms are in clear view.
It may be necessary to have subject adjust clothing in order to adequately determine that a device is not being concealed on his/her body.

21. Urine Collection-Step
The subject will rinse hands with cold water (no soap) and dry them thoroughly.
Purpose of rinse is to eliminate any agent the subject may use to contaminate their urine.

22. Urine Collection-Step 7
The collector hands the labeled bottle to the subject and positions himself in a manner to directly observe urine leave the body and enter the specimen bottle.

23. Urine Collection-Female
A clean, wide-mouthed disposable cup is used to catch urine. The urine is then transferred to the specimen bottle by the subject.

24. Urine Collection-Female
Because it may be impossible to see urine leave the female body and enter the disposable cup, other procedures must be employed to insure a urine substitution does not occur.
•Ask the female subject to hold the cup with one hand, and place the other hand against the wall, or in clear view away from the cup.
•Ask the female subject to begin the flow of urine, stop the flow, and resume the flow, insuring that urine is actually coming from her

25. Urine Collection-Step 8
After urine is collected, the subject places the cap firmly on the bottle to prevent leakage.
•The collector should not handle the bottle, especially if it is not capped.

26. Urine Collection-Step 9

27. Positive On-Site Complete On-site Chain of Custody Form
Have offender/defendant fill out comment section and sign
Include Kroll Chain of Custody Form # on Onsite Chain of Custody Form
Notify USPO/USPSO via fax immediately of positive on-site test result
Do not bill for both 1010 (lab) and 1011 (onsite), it is one collection

28. Positive On-Site (continued):
Follow proper procedures for packaging and mailing specimens as listed in the SOW
Fill out Kroll Chain of Custody Form
Do not include s.g. on Chain of Custody form
Do NOT request primary or secondary test panel
Request “confirmation only” and list presumptive positive test(s)
Upon receipt of lab result, fax results (positive or negative) to USPO/USPSO immediately

29. Urine Collection-Step 10
The subject shall place the UA specimen into the pocket containing an absorbent sheet of a tamper evident bag.

30. The collector shall fold the form, place it into the document pocket, tear adhesive lining, and fold adhesive flap over front pocket to insure a secured seal.

32. Urinalysis Log All specimens must be listed on the UA log
UA Log is submitted monthly with the invoice
May alter your UA Log with approval from Substance Abuse Coordinator

33. Completing the Laboratory Chain of Custody Form

34. Must be legible
Must print
Must keep letters/numbers within the boxes provided
Must include officer initials
Must include PACTS number

35. Incorrect COC Primary test requested with confirmation
Names not in fields
Incorrect officer initials

36. Incorrect COC PACTS number not inside boxes Name in incorrect field
Requested 2 tests
Specific gravity listed on form

38. Illegible
No collectors name
Specific gravity listed

39. Storage and Delivery
The bagged specimen shall be placed into a shipping box and kept in a secured area.
UA specimens must fit comfortably in the box and should not be packed so tightly as to compromise the tamper evident seal, COC form, or box itself.
Follow proper FedEx procedures for shipping clinical specimens.

40. Behavioral Issues
Please refer offender to the US Probation Office if they are found with any type of device

41. DILUTE URINE
Dilute urine can be an indication that a subject is attempting to “flush” his/her system with excess fluid to avoid drug detection.
Products sold to “beat drug tests” commonly use flushing as the method to avoid detection.
It is important to note on the COC form if urine appears dilute.
If a pattern of providing dilute urines is noticed, the collector should communicate this with the officer.

42. Stalling & Subsequent Attempts
If the subject is unable to provide a sample, the collector shall complete the appropriate section of the COC form noting the “stall” and fax it to the supervising officer. The bottle should be disposed of in a trash receptacle in a secured area.
DO NOT re-use the first form nor the bottle for any future collection, including a subsequent attempt by the same subject. A new form and a new bottle must be used.
If the subject is able to submit a sample in a subsequent attempt on the same day, the COC form indicating the stall should be destroyed.

43. NO TEST Sample arrives at on-site lab without the COC form
Tamper evident seal is broken or missing
COC form is not signed by either the collector or the subject
Specimen ID on bottle label and COC form do not match
No initials by subject on red tamper e. seal
White specimen ID label overlaps red tamper e. seal (AKA Incorrect Collection Procedure)

44. BREATHALYZER

45. Alcohol Breath Testing
Alcohol testing no longer by urine
Do not exceed breathalyzer frequencies listed on Program Plan
Vendor responsible for training staff and calibration of units
Must begin on January 1

46. Alcohol Breath Testing
Notify USPO/USPSO immediately of positive reading and document on Chain of Custody form
Include all breathalyzer results on Monthly Treatment Report

47. Sample Breathalyzer Log

48. Monthly Treatment Report (MTR)

49. Testing Information must include:
Days of the week
Type of test (on-site vs lab)
Result of test(s)
Specific gravity
medication (if applicable)
Bus tokens/passes
Co-payment

50. MTR Comment Section
If receiving more than one service (i.e testing, individual or group counseling, IOP), progress of all treatment must be combined and summarized
Summary should be informative and specific to the individual client
NO canned language

51. Notification Reports
Vendor responsible for creating own notification reports (for review by Substance Abuse Coordinator)
Must include all pertinent information
Type of violation
FTA (counseling/testing/intake)
Stall/ low specific gravity
Positive result (onsite, breathalyzer, or lab)

52. Notification timelines:
Positive Test
Due immediately
Failure to appear for services
Discharge Summary
Due within 15 days

53. Supplies and Inventory

54. Supplies Supplies from USPO/USPSO include:
Sweat patch
On-site (NIDTs) 6-panel and single MDMA
Kroll laboratory
Bottles
Baggies
Chain of Custody Forms
Mailing supplies
Must keep USPO and USPSO supplies separate

55. Supplies (con’t)
Probation Onsite tests, and laboratory supplies are ordered through Carla Garcia (562)
Pretrial supplies are ordered through Brenda Mercado (213)
Order before you run out
May take 2 weeks (business days) to receive supplies

56. Inventory
Monthly probation inventory must be submitted by the 10th of each month to Substance Abuse Coordinator- Jennifer Smith
Monthly pretrial inventory must be submitted the 10th of each month to Senior USPSO Adriana Corona-Buergo
Inventory includes # of devices received and used during the proceeding month

57. Sweat Patch Log
Must be sent to Substance Abuse Coordinator Jennifer Smith by the 10th of each month

58. Termination of Services

59. Program Plan does not require offender/defendant signature
Include in your file
If counseling provided, must complete a typed discharge summary to USPO/USPSO within 15 calendar days

60. Monitoring
Will be reviewed at least two times the first year of the contract
If unsatisfactory rating, you will have a follow up review
Deficiencies can result in a Cure Notice that requires a formal response
You will be held to the standards in the proposals you submitted

61. SWEAT PATCH TRAINING For outpatient testing only
Only for staff never trained before
Approx. 1 hour
Test at end
Will receive certificate in mail

62. Questions?? Comments