INITIAL COMMENTS
|
This report is a result of an on-site complaint investigation conducted on March 1-2, 2022 by staff from the Bureau of Program Licensure. Based on the findings of the on-site complaint investigation, New Directions Treatment Services was found not to be in compliance with the applicable chapters of 28 PA Code which pertain to the facility.
|
Plan of Correction
|
715.19(1) LICENSURE Psychotherapy services
A narcotic treatment program shall provide individualized psychotherapy services and shall meet the following requirements:
(1) A narcotic treatment program shall provide each patient an average of 2.5 hours of psychotherapy per month during the patient 's first 2 years, 1 hour of which shall be individual psychotherapy. Additional psychotherapy shall be provided as dictated by ongoing assessment of the patient.
|
Observations
Based on a review of patient records, the facility failed to provide each patient with 2/5 hours of psychotherapy per month during the patient's first 2 years of treatment in two out of six records reviewed.Patient # 4 was admitted on October 13, 2021 and was an active patient at the time of the investigation. In November 2021, the patient had 45 minutes of individual therapy and 0 hours of group therapy. In December 2021 the patient had 45 minutes of individual therapy and 0 hours of group therapy. In January 2022 the patient had 1 hour and 45 minutes of individual therapy and 0 hours of group therapy. In February 2022 the patient had 0 hours of individual therapy and 0 hours of group therapy.Patient # 5 was admitted on September 1, 2021 and was an active patient at the time of the investigation. In January 2022 the patient had 1.5 hours of individual therapy and 0 hours of group therapy. In February 2022 the patient had 1.5 hours of individual therapy and 0 hours of group therapy.
|
Plan of Correction
On March 8, 2022, the Program Director met with all of the counselors during group supervision and reviewed the state regulations and requirements pertaining to the minimum counseling attendance requirements for any client receiving medication assisted treatment for less than two years. Specifically, policies and rules were addressed ensuring that clients receive a minimum of 2.5 hours of counseling per month during the first two years of treatment. During the meeting on 3/8/2022, counselors were also reminded about the requirement to meet the counseling attendance requirement of one hour each month following two years of treatment, and one hour of counseling every other month after four years of treatment. To ensure ongoing compliance, the Program Director will meet with counselors during individual supervision to monitor and review counseling attendance records and clinical documentation, making certain that the counselors are using appropriate and necessary interventions to assist clients in meeting the state regulatory requirements. In addition to group supervision that was facilitated on 3/8/2022, the Program Director spoke to the counselors overseeing Client #4 and Client #5, during individual supervision, and discussed effective strategies to implement so that the minimum 2.5 hours of counseling are met each month moving forward. |
715.19(3) LICENSURE Psychotherapy services
A narcotic treatment program shall provide individualized psychotherapy services and shall meet the following requirements:
(3) After 4 years of treatment, a narcotic treatment program shall provide each patient with at least 1 hour of group or individual psychotherapy every 2 months. Additional psychotherapy shall be provided as dictated by ongoing assessment of the patient.
|
Observations
Based on a review of patient records, the facility failed to provide each patient with at least 1 hour of group or individual psychotherapy every 2 months after 4 years of treatment in one of six records reviewed.Patient # 1 was admitted on April 4, 2014 and discharged on December 17, 2021. The patient had 30 minutes of individual therapy and 0 hours of group therapy in September 2021. The patient had 0 hours of individual therapy and 0 hours of group therapy in October 2021. The patient had 0 hours of individual therapy and 0 hours of group therapy in November 2021. The patient had 0 hours of individual therapy and 0 hours of group therapy in December 2021.
|
Plan of Correction
During group supervision held on March 8, 2022, the Program Director met with the counselors and re-educated them about the state regulatory requirements pertaining to counseling for clients who have been in treatment for four years. Specifically, the counselors were reminded that they must provide at least one hour of group or individual counseling/therapy every two months after a client has been in medication assisted treatment for four years. Counselors were instructed to utilize spreadsheets outlining a client's admission date, as well as the date of their last counseling session, so that they know when the next appointment will be due. On March 8, 2022, the Program Director met individually with the counselor overseeing Client #1 and discussed specific strategies that can be implemented, such as spreadsheets and calendar reminders, to ensure that the minimum counseling requirements will be met. To ensure ongoing compliance, the Program Director will conduct random record reviews during individual supervision to review counseling attendance and the frequency of sessions. |