RSM 6, Section 300: WTC Client Services

Updated: 3/25

301 Admission Criteria

301.01 Purpose

To establish policies and procedures for the review, evaluation, acceptance or rejection of referrals for admission to WTC.

301.02 Applicability

All referrals for admission to programs and services offered by WTC.

301.03 Policy Statement

WTC will meet COMAR 13A.11.08.04 Admission Criteria regulations.
WTC will meet COMAR 13A.11.08.05 Admission Decision and Appeal Process regulations.
WTC will meet RSM 2, Section 1204, Admission to the Center policy and procedures.

301.04 Procedures

All WTC staff who review referrals for services will make determinations consistent with the spirit and intent of the Rehabilitation Act of 1973, as amended. In all aspects of working with referral sources and consumers the goal is to provide the most appropriate and thorough services in support of employment as quickly as resources allow.

Referral procedures documented in RSM 2, Section 1204, Admission to WTC will be met.

A person may not be denied admission to WTC solely on the basis of the person's race, color, sex, age, ancestry/national origin, religion, disability, gender identity/expression or sexual orientation.

The admission committee consists of the WTC Administrative Services Program Manager, WTC case manager, and the other team members, as deemed necessary. The admission committee shall comply with DORS Order of Selection for Services policy set forth at COMAR 13A.11.01.13.

The Center Services Team (CST) consists of a group of staff members who review service authorizations for consumers referred for Career & Technology Training programs and Work Readiness Services programs (WRP). If the consumer meets the minimum criteria for Career & Technology Training and/or WRP, the CST provides an admission date. Additional information can be pursued after the scheduled admission date is set but will not cause the scheduled admission date to be altered. A plan to address issues learned after the scheduled admission date will be developed and implemented upon admission. The Center Services Team is considered a “case manager” and must meet the procedures noted in this policy unless specified below.

The assigned case manager shall review the service authorization and supporting documentation and, based upon the criteria set forth in this regulation, make a decision to admit the applicant or to recommend to the admission committee denial of the applicant. Consumers assigned to the Center Services Team as the assigned case manager will initially be referred to the WTC Leadership Team when there is an issue or concern with the referral. If the WTC Leadership Team does not resolve the issue or concern, the case manager will refer the referral to the admissions committee. When a case manager for other WTC programs and services has issues or concerns with referrals, the case manager should contact their supervisor for guidance. If the issue cannot be resolved, then the referral will go to the admissions committee.

The case manager shall make the final decision to admit an applicant to WTC based upon the following criteria or send the referral for review by the admissions committee if the issues or concerns couldn’t be resolved at the lowest management level (see RSM 2, Section 1204):

The person is an applicant for or recipient of vocational rehabilitation services provided by DORS or by a public or private organization or agency with an established direct referral agreement with WTC.
The services and resources needed to address the functional limitations presented by the applicant are available at WTC.
There is evidence that the:

Applicant has the developmental, personal, and social skills necessary for self-directed activity and participation in a program of rehabilitation conducted in group settings, and
Admission request is voluntary on the part of the applicant, and
Current health status of the applicant permits participation in a program of rehabilitation services.
The Applicant who will be residing in the dormitory is able to independently take medication.

The applicant to an employment skills training program meets standards for admission and has a reasonable expectation of successfully completing the program and being employed in the field.

Based on referral information received, the assigned case manager/center counselor may request the DORS Chief of Police to conduct a Maryland Judiciary Case Search to obtain additional information. This includes but is not limited to criminal history, sexual offenses, court-ordered provisions, and parole/probation, etc.

An applicant may be admitted for services if the case manager/center counselor determines that the applicant is independent in activities of daily living and will be able to function with minimal supervision. If the need for assistance with activities of daily living has been identified, then procuring a Direct Care Assistant via the available contract will be arranged by the Behavioral Health Services' Health Educator.

Referral information confirms that the applicant who seeks admission for assessment or training services meets criteria specific to the service or program.

An applicant who has been determined to have a communicable disease may not be admitted. Individuals with HIV/AIDS may be admitted.

Applicants will be scheduled once all necessary documentation has been received. When a wait list is in effect, applicants will be contacted and scheduling will be coordinated based on the applicant's availability and the next available slot.

Criteria Established for Specific Programs:

Career & Technology Training Services – Documentation is required that the applicant to an employment skills training program has met the established minimum requirements and other criteria (e.g., valid driver's license), and being employed in the field. Usually the necessary documentation is a recommendation for the requested training area from a community rehabilitation program assessment that addresses the minimum requirements for the program. Other documentation is handled on a case-by-case basis. In all deliberations, the emphasis is on the eventual employability of the applicant.

301.05 Admission Denial and Appeal Process

(See RSM 2, Section 1204.04.)

The admission committee may deny admission to an applicant who, in its determination, presents a danger to the health and safety of other clients and staff at WTC or presents a condition that WTC does not have adequate resources to care for appropriately, including, but not limited to, an applicant:

Who is behaviorally or psychiatrically unstable or dangerous to a degree which requires intensive supervision or a restrictive therapeutic environment as documented by a licensed physician or psychologist;
Who is acutely ill or medically unstable, as documented by a licensed physician, and requires medical, surgical, or nursing care beyond the resources of WTC;
Who is currently using or abusing illegal drugs or alcohol;
Who is a minor and who requires, in order to participate in a program of services, separate residential facilities for care or treatment as may be required by State law or regulation;
Who is incarcerated or required to be under the strict supervision of law enforcement officers; or
Who does not have established housing:

for weekends
other times when WTC is closed, or
upon completion of their service or program.

The admission committee shall notify the applicant and referral source of the admission denial. The admission committee shall respond in writing and:

State its reasons for denial.
Inform the applicant and referral source of the Client Assistance Program (CAP) and appeals process.
When appropriate, provide alternative recommendations for addressing the functional limitations presented by the applicant.

The referral source, the applicant for services, or the applicant's representative may request reconsideration of a decision denying admission within 30 days of receipt of the admission committee's decision by requesting, in writing, an opportunity to appear before the admission committee.
If the admission committee, after reconsidering, confirms the decision to deny admission, the applicant may request an appeal hearing in accordance with COMAR 13A.11.07.03.

301.06 Responsibilities

The WTC Program Director is responsible for the administration of this policy.
The WTC Leadership Team is responsible for the implementation of this policy.
The Authorization Case Manager and Center Services Team are responsible for adhering to WTC admission procedures.
The Authorization Case Manager is responsible for reviewing and approving referrals for admission to the Dorm/SRD.
The Admissions staff is responsible for screening referrals for services and directing them to the appropriate Case Manager for scheduling.
The Admissions Committee is responsible for evaluating and reviewing referrals when issues or concerns are identified and processing denials.

302 WTC Orientation

302.01 Purpose

To establish policy and procedures for conducting the orientation of individuals who are admitted for services to WTC.

302.02 Applicability

All individuals admitted to programs and services offered by WTC.

302.03 Policy Statement

Each person admitted to WTC shall be provided with orientation services addressing both general operations of WTC and specific matters associated with enrollment into a program of services.

302.04 Procedures

WTC will meet COMAR 13A.11.08.12 Client Orientation regulations (see RSM 2, Section 1207.03).
Each client admitted to WTC shall be provided with orientation services addressing both general operations of WTC and specific matters associated with the client's enrollment into a program of services.
WTC's Admission Packet, which includes the rules and regulations, shall be presented in writing, supplemented as necessary by appropriate modes of communication, to the client during the admission process. The client or, as appropriate, the client and the client's representative, shall acknowledge receipt of a copy of the regulations and procedures associated with participation in a program of services at WTC by signing the document.
The orientation program shall also include, as appropriate, introduction to the specific program area or areas involved in the delivery of services.
The client shall be informed of the attendance policies relating to the program of services in which the client is enrolled, and the consequences which may result if the client is absent without authorization.
WTC's Admission Packet, which includes the Consumer Bill of Rights, shall be presented in writing, supplemented as necessary by appropriate modes of communication, to the client during the admission process. The client or, as appropriate, the client and the client's representative, shall acknowledge receipt of a copy of the Consumer Bill of Rights and confirm they have been provided the opportunity for clarification of their rights at WTC and of the methods and procedures available to present a complaint, seek review or appeal of any decisions involving the provision or denial of services, or address any other matter which may be of concern while enrolled in WTC, by signing the document.
A client residing at the WTC Supported Residence Dormitory (SRD) will be informed of the curfew during the SRD orientation. This procedure is applicable to all SRD clients, no matter of age of client. Information to be shared includes:

Client must be in their room by 11:00 p.m.
Client who will be returning after curfew, must inform a residential advisor prior to curfew. Client needs to provide their cell phone number, the anticipated time of return, where they are going, and a name and phone number of the person they will be with.
Client will be informed that if they do not return and do not answer their phone, the residential advisor will call the contact person provided. If the contact person does not respond, then the residential advisor will call the client’s emergency contact listed in AWARE™ (confirmed at admission). If the emergency contact cannot be reached or is unaware of the location of the client, then the police will be called to file a missing person report regarding the absence of a vulnerable adult.

302.05 Responsibility

The WTC Program Director is responsible for administration and implementation of this policy.
The Case Managers or Responsible Providers are responsible for meeting with new admissions the day of admission.
The Admissions staff is responsible for completing the admission process.
Residential Services staff are responsible for orienting residential individuals to the Supported Residence Dorm.

303 Consumer Rights and Responsibilities and Nondiscrimination Policy

303.01 Purpose

To establish a policy and procedures to promote and protect the interest of individuals with disabilities served by WTC.

303.02 Applicability

WTC staff, vendors, volunteers, student interns and consumers.

303.03 Policy Statement

In order to promote, protect and preserve the best interests of individuals with disabilities served by WTC, the following policy is established and will provide the basis for the delivery of services:

The Maryland State Department of Education does not discriminate on the basis of race, color, sex, age, national origin, religion, disability, gender identity or sexual orientation in matters affecting employment or in providing access to programs and activities.

303.04 Procedures

The implementation of consumer rights and responsibilities associated with applicable federal and state laws and regulations as well as DORS and WTC standards will include but not be limited to the following procedures:

Resident consumers will be assigned rooms in a manner consistent with Title VI of the Civil Rights Act of 1964; Section 504 of the Rehabilitation Act of 1973, as amended; the Age Discrimination Act of 1975, as amended; and the ADA of 1990, Titles II and III, Tile 20 of State Government Article, and DORS Policy, RSM 2, Section 1206.
Resident consumers will not be asked if they are willing or desire to share a room with a person of another race, color, sex, age, national origin, religion, disability, gender identity or sexual orientation.
All consumers have the right to utilize the bathroom consistent with their gender identity, regardless of their gender assigned at birth. WTC also has single-stall gender-neutral bathrooms available.
WTC personnel shall observe appropriate standards including knocking on doors in the residential areas and awaiting a response before entering.
WTC employees will be assigned to consumer services without regard to race, color, sex, age, national origin, religion, disability, gender identity or sexual orientation of either the consumer or employee.
WTC will maintain and assure the availability of both staff and physical resources required to provide access to services and programs by persons with special communication, mobility and sensory limitations.
All consumers will be provided a copy of the WTC General Rules and Regulations at the time of admission. The consumer will indicate receipt of the WTC General Rules and Regulations by signing the acknowledgment form.
Disciplinary actions which may be required in the event of a violation of WTC rules and regulations will be applied fairly and in a manner which supports and promotes the health, welfare, safety and rehabilitation program of the individual and all other clients and staff of WTC.
The WTC Director or the Director's designee may authorize searches of the physical plant including lockers and residential areas assigned to individual clients when there is a reasonable belief that the search is essential to prevent imminent danger to the safety or welfare of a client, an employee or other persons on WTC property, or that the search will produce evidence that the client has violated or is violating either the law or rules of WTC. A search of the physical plant may be undertaken without advanced authorization if imminent danger to the health, welfare or safety to the consumer or others exists. The WTC Director or Designee will be immediately notified of any search that was conducted without advanced authorization. All searches shall be made in the presence of a third party (COMAR 13a.11.08.19).
Consumers will have the right to receive visitors Monday through Thursday from 6:30 p.m. until 9:30 p.m. Parents, spouses, representatives and other persons with responsibilities related to the management of a consumer’s program may visit at other times as circumstances require but are requested to avoid interrupting, insofar as possible, the evaluation and training services being provided. Consumers may address special needs associated with this procedure by contacting their Case Manager.
Consumers shall receive respect and privacy in the implementation of their individualized programs. Case discussion and consultation are confidential.
Consumers may present complaints regarding the provision or denial of services to any staff person. Staff should first attempt to resolve the complaint at the lowest organizational level. If immediate resolution of the problem cannot be made by the staff person receiving the complaint, the consumer may elect to complete the Client Complaint Form (RS-WTC-1b) and forward it to the WTC Risk Manager. This procedure will be reviewed during consumer orientation. Consumers may, in addition to utilizing the Center’s internal complaint procedure, initiate actions associated with their rights under DORS Appeal Process and may request services through the Client Assistance Program (Section 206). Consumer complaints will not result in retaliation or barriers to services.
Every consumer will be provided with and have explained the WTC Admissions’ Agreement detailing any charges associated with the provision of services, arrangements for third party sponsorship, and any other financial matters.
Consumers served are protected from physical, sexual, psychological, and fiduciary abuse; harassment and physical punishment or neglect; and retaliatory, humiliating, threatening, or exploiting actions.
Consumers have the right to be informed that an observer will be at their meeting or appointment with as much notice as possible. Consumers will be informed of the reason for the observer and the observer’s role at the appointment or meeting. Consumers have the right to refuse an observer in a counseling session.
Consumers who wish to have an observer must request approval from the WTC service provider. WTC service providers may decline the request if they feel that the observation will affect the results of the meeting or appointment.
Consumers have the right to be referred to by their preferred name, preferred pronoun, and have their preferred name listed on their WTC identification card, and dormitory room tag and board. While accidental misuse of a consumer’s preferred name and pronouns may occur, intentionally and repeatedly using the wrong name and pronoun by staff is not acceptable.

303.05 Responsibilities

The WTC Program Director is responsible for assuring that Consumer Rights and Responsibilities and Nondiscrimination policies are maintained and consistently applied.
All staff, vendors, student interns and volunteers are responsible for developing and/or providing services for individuals consistent with this policy and procedures.
Supervisors are responsible for implementing the provisions of this policy and procedures as they relate to their specific program areas.
The Administrative Services Assistant Director is responsible for planning and implementing necessary training associated with the provisions of this policy and procedures.
The investigation and resolution of initial complaints is the responsibility of all permanent staff.
The WTC Risk Manager shall receive and investigate all formal complaints from consumers.
The resolution of formal complaints (Client Complaint Form (RS-WTC-1b)) is the responsibility of the WTC Risk Manager, the Department Supervisor and the WTC Program Director.
WTC consumers must carry out their responsibilities as specified in WTC rules, regulations and other information provided during admission and/or orientation.

304 Room, Board and Enrichment (RB&E)

304.01 Purpose

To establish policies and procedures for applicants accepted to WTC for room, board and enrichment (RB&E) services.

304.02 Applicability

All individuals admitted to WTC for RB&E services.

304.03 Policy Statement

RB&E will be offered to accommodate individuals who require room and board to facilitate access to community services. This service includes residence, meals, enrichment opportunities and support services.

304.04 Procedures

All applicants for RB&E are subject to the WTC admission criteria (see Section 301 and RSM 2, Section 1204).
Referral information will reflect individual’s ability to travel and function independently outside of WTC.
The WTC RB&E Center Counselor will provide coordination of services as identified in the IPE for all RB&E individuals including the following:

Provide transportation costs to program (i.e., bus pass, tokens).
Arrange bag meals from cafeteria, as needed.
Recommend to the referring field counselor, support services, which may be needed to assist the individual in maintaining their rehabilitation program.

The Residential Services Department will provide orientation, linen, crisis intervention, and assistance to dormitory residents who are independent in their activities of daily living.

304.05 Responsibility

The WTC Program Director is responsible for the administration and implementation of this policy.
The RB&E Center Counselor is responsible for case management services; coordinate all aspects of the individual’s program with the individual, the interdisciplinary team, the referral source, and other interested parties; and will provide supportive counseling and guidance throughout the individual’s stay at WTC.
The staff of Residential Services Department is responsible for providing residential services to individuals residing on the dormitory.

305 Disciplinary Action for Consumers

305.01 Purpose

To establish consumer disciplinary procedures to assist in correcting inappropriate behaviors.

305.02 Applicability

All consumers receiving services at WTC.

305.03 Policy Statement

WTC will implement disciplinary action for consumers based on RSM 2, Section 1210 and COMAR 13A.11.08.11 Disciplinary Action regulations.

305.04 Procedures

COMAR 13A.11.08.11 Disciplinary Action:

The WTC Director or the Director's designee may take appropriate disciplinary action against any client who violates WTC's regulations and procedures, or whose behavior is disruptive to the operations of WTC's programs and services. The severity of the disciplinary action shall be based on the nature and scope of the client's behavior. Disciplinary action may range from imposing appropriate restrictions on the client's privileges at WTC to temporary or permanent suspension from WTC.
Restrictions on Privileges – The case manager and/or residential staff, as appropriate, may impose appropriate disciplinary actions involving restrictions on privileges and shall inform the client of the disciplinary action and the reasons for the action. The case manager and/or residential staff, as appropriate, shall, in a timely manner, notify the referral source of the disciplinary action and reasons for the action.
Temporary or Permanent Suspension:

WTC's Assistant Director, with the active participation of the referral source, shall implement the temporary or permanent suspension of a client from WTC.
The Assistant Director shall:

Give the client oral and written notice of the suspension and the reasons for the suspension.
Inform the client and the client's representative of the Client Assistance Program (CAP).
Inform the client and the client’s representative that the client may request reconsideration of the Assistant Director’s decision to the WTC Director.
Inform the client and the client's representative that the client may appeal the decisions in accordance with COMAR 13A.11.07.03.
Notify the referral source in writing of the client's suspension.

A temporary suspension may not exceed 30 program days on the first occurrence.
A client whose presence in WTC poses a continuing danger to self or others may be suspended from WTC immediately, pending the reconsideration and appeal process.
The disciplinary action taken against a client shall be documented in the client's record.
A client who has been temporarily suspended from a program of services may not be permitted to return to WTC until a case conference is held between the client or the client's representative, the case manager, the referral source and any other WTC staff who are providing services to the client. At the case conference, the case manager shall establish the conditions under which the client may return to WTC, including any restrictions which may be imposed, or whether the suspension should be extended or made permanent.

305.05 Responsibility

The WTC Director is responsible for the implementation of this policy.
The WTC Director is responsible for reviewing the client’s request for reconsideration of the Assistant Director’s disciplinary action decision.
The Assistant Director is responsible for determining the disciplinary action and for insuring that, when making these decisions, that the rights of the client have been respected.
The Case Manager’s Supervisor is responsible for reviewing and approving the Case Manager’s request for disciplinary action.
The Case Manager is responsible for implementing the disciplinary action. The Case Manager is also responsible for arranging a case conference before a temporarily suspended client may return to the Center.
The Case Manager is responsible for imposing restrictions on privileges when appropriate and for notifying both the client and the referral source of the reasons for these actions in a timely manner.

306 Discharge of Consumers from WTC

306.01 Purpose

To establish policy and procedures for the planning and discharge of consumers from WTC.

306.02 Applicability

All consumers served at WTC.

306.03 Policy Statement

The Center will meet COMAR 13A.11.08.09 Discharge Planning regulations.

The Center will meet COMAR 13A.11.08.10 Discharge regulations.

306.04 Procedures

COMAR 13A.11.08.09 Discharge Planning (see also RSM 2, Section 1211):

For clients receiving employment skills training, the case manager/center counselor and the client shall initiate a discharge plan upon the client's admission to WTC and document the discharge plan in the record. The case manager/center counselor shall include in the discharge planning process:

The client
Family members or others who can provide support and assistance to the client
Members of the interdisciplinary team who may be involved in the delivery of services to the client
The referral source

The case manager/center counselor shall notify the client, the client's family, representative, the referral source, and rehabilitation team members of the proposed discharge date.
The case manager/center counselor for clients receiving employment skills training shall hold a discharge conference with the client on or shortly before the day of discharge to summarize services, discuss issues, and outline the steps needed to facilitate transition to the next phase of the client's rehabilitation program. The client shall be informed that a written report will be submitted to the referral source in a timely fashion after the conclusion of the service.

COMAR 13A.11.08.10 Discharge:

WTC staff may discharge a client from WTC under any of the following circumstances and with the active participation of the client, client’s representative and referral source:

The client satisfactorily completes the rehabilitation program as presented in the client's service plan.
The client meets the requirements for graduation from an employment skills training program.
The client initiates voluntary termination of the program.
The client's medical condition prevents continued participation in a program of services.
The client exhibits behavior which is dangerous or harmful to the client or to others in accordance with Regulation .11.
The client is permanently suspended as a result of disciplinary action in accordance with Regulation .11; or
The client dies.

WTC’s Assistant Director may discharge a client from WTC under any of the following circumstances and with the active participation of the client, client’s representative and referral source:

The client fails to achieve satisfactory progress, based upon the service plan, and efforts to resolve the issues contributing to the lack of progress are unsuccessful; or
The client is absent for more than three full program days without providing an acceptable reason to the case manager.

A client or a client's representative may request reconsideration of the decision to discharge by the WTC Director within three days of being notified of the decision. The WTC Director shall confirm or overturn the decision within 24 hours of the request, during which time the client may remain at WTC and receive services.

If the discharge decision is confirmed pursuant to §b2, at the time of discharge from WTC, the client, the client's representative and the referral source shall be given written notification of the:

Reason for discharge
Availability of the Client Assistance Program
Appeal process in accordance with COMAR 13A.11.07.03.

If the discharge decision is confirmed pursuant to §b2 and the client pursues an appeal hearing in accordance with COMAR 13A.11.07.03, the client may remain at WTC and receive services pending the appeal process.

A copy of the discharge summary shall be forwarded to the referral source and included in the client's record.

306.05 Responsibility

The WTC Program Director is responsible for the implementation of this policy.
Supervisors are responsible for implementing the provisions of this policy and procedures as they relate to their specific program areas.
The Case Manager is responsible for following the procedures listed above.

307 Substance Abuse Support Services

307.01 Purpose

To define and clarify admissions procedures and the provision of substance abuse support services at WTC.

307.02 Applicability

All Individuals referred and admitted to WTC.

307.03 Policy Statement

WTC provides substance abuse support services to assist individuals to maintain a recovery lifestyle as they work toward employment and independence. The services include individual substance abuse counseling, monitoring, group meetings, and referral to local Alcoholics Anonymous and Narcotics Anonymous meetings. WTC's substance abuse support services are not "treatment," and individuals requiring a treatment program shall be referred to community treatment providers.

While individuals are not required to meet any pre-determined readiness criteria, such as an abstinence time frame as a condition for admission, they must be taking measures, e.g., through participation in treatment or support groups, that demonstrate commitment to the recovery process.

WTC is a drug-free environment. Individuals found to possess alcohol or illegal substances on the premises of WTC may be discharged (see Section 305, Disciplinary Action for Consumers, and Section 306, Discharge of Consumers from WTC).

307.04 Definitions

Abstinence – Total cessation of substance use and represents the desired treatment outcome for individuals with a substance-related disorder.
Diagnosis – The process of identifying or determining a substance abuse or substance dependence problem through evaluation of history, examination, and review of laboratory data of the individual by a licensed or certified substance abuse treatment program, or by a certified addictions counselor assessment with a physician’s authorization.
History – An established record or pattern of behavior from a person who reports any use and/or abuse of alcohol or other drug use in their past.
Recovery – The process by which a person learns new meaning in life beyond the illnesses of substance abuse. When individuals are "in recovery," it is implied that they are abstinent from substances, but also that they are participating in life activities that are meaningful and fulfilling for them. Recovery also implies that the person is able to function in meaningful activities. Integrated dual diagnosis treatment is designed to help people not only become abstinent, but to enter a recovery process. (Source: Evidence-Based Practices; Shaping Mental Health Services Toward Recovery, Co-occurring Disorders: Integrated Dual Disorders Treatment Workbook, Chapter 1, SAMSHA’s National Mental Health Information Center, Center for Mental Health Services.)
Reasonable Suspicion – Those circumstances where there are reasonable, concrete, and specific grounds to believe that a urine screening (or breathalyzer sample) taken from an individual will produce evidence of the illegal (or unauthorized) use of drugs or alcohol such as, but not limited to:

Direct evidence, such as direct observation of alcohol or drug use, or possession of alcohol or illegal drugs.
Testimonial evidence, such as reports from other students, staff, or other parties of direct observation of use or possession.
Other cases where reasonable suspicion may be based on what is referred to as "patterns of abnormal conduct, or erratic behavior." In such situations, characteristics of the individual's disability and usual behavior shall be considered.

Substance Use Disorders – A problematic pattern of substance use leading to clinically significant impairment or distress (DSM-5, 2013), as manifested by at least two of the following, occurring in a 12-month period:

Substance is often taken in larger amounts or over a longer period than was intended.
There is a persistent desire or unsuccessful efforts to cut down or control substance use.
A great deal of time is spent in activities necessary to obtain the substance, use, or recover from its effects.
Craving, or a strong desire or urge to use the substance.
Recurrent substance use resulting in a failure to fulfill major role obligations at work, school or home.
Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance.
Important social, occupational or recreational activities are given up or reduced because of the substance use.
Recurrent substance use in situations in which it is physically hazardous.
Substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance.
Tolerance, as defined by either of the following:

A need for markedly increased amounts of a substance to achieve intoxication or desired effect.
Markedly diminished effect with continued use of the same amount of a substance.

Withdrawal, as manifested by either of the following:

The characteristic withdrawal syndrome for the substance (Refer to the DSM-5, 2013, pages 481-585)
The substance (or a closely related substance) is taken to relieve or avoid withdrawal symptoms.

307.05 Procedures

Referral
WTC Center Services Team and Case Managers shall review records of referrals for WTC services to identify consumers who would benefit from WTC Substance Abuse Support Services.

Individuals with a recent history or diagnosis of substance abuse are required to:

Agree to participation in WTC substance abuse support services while at WTC, including testing (urine and/or breathalyzer) for the presence of alcohol or other drugs on a random basis and/or with reasonable suspicion of use.
Sign the **WTC Substance Abuse Fact Sheet (RS-4n)** to assure they understand that WTC is a substance-free facility and requirements for participation in WTC substance abuse support services, including the requirement to sign and abide by the WTC Substance Abuse Support Services Agreement, while at WTC.

WTC staff shall coordinate with the field counselor regarding an individual's participation in community addictions services, including methadone maintenance, and how such participation may interface with WTC substance abuse support services.

Admission

Individuals identified as needing WTC Substance Abuse Support Services shall meet with the Addictions Specialist within three working days of admission to WTC. The Addictions Specialist shall explain services and monitoring protocols, and review/sign the **Substance Abuse Support Services Agreement** and have the consumer sign, and arrange for an initial urine sample.
Individuals being readmitted after a discharge due to usage of alcohol or drugs shall agree to an Addictions Action Plan effective upon admission which will be developed by the case manager/center counselor with input from the Addictions Specialist.
Any consumer arriving for admission who is reasonably suspected of being intoxicated or under the influence of alcohol or an illegal substance will be admitted for services. The consumer will receive urine testing and an Addictions Assessment. Based on the results, an Addictions Action Plan may be developed. DORS Police shall be contacted if the individual responds in a belligerent or violent manner.

Reasonable Suspicion of Substance Use

Students receiving services at WTC who demonstrate behaviors leading to reasonable suspicion (see definition above) or self-report intoxication or substance use, will be requested to agree to a breathalyzer and/or urinalysis immediately.
The case manager/center counselor shall be contacted immediately. DORS Police shall be contacted if the individual responds in a belligerent or violent manner.
When the suspicion of substance use occurs on the evening or night shift, then the WTC Residential and Enrichment Services staff shall interview the individual to determine their medical stability and if additional medical or monitoring action to address this issue is warranted. See **Suspicion of Substance Use Procedures (RS-WTC-4h)**.

Positive Findings of Drug/Alcohol Testing.

If a consumer reasonably suspected of being under the influence or scheduled for random monitoring declines to provide a urine sample or undergo a breathalyzer, he/she will be assumed to have a positive finding of the test.
As soon as a positive finding is confirmed, the case manager/center counselor and Addictions Specialist shall consult with the WTC Program Director or designee regarding the likelihood that the individual may have used alcohol or illegal substances at WTC and whether a dormitory room and/or locker search would be appropriate. DORS Police shall be contacted if a search is warranted; established protocol for room search shall be followed. Individuals found to possess alcohol or illegal substances on the premises of the WTC may be immediately suspended based on Section 305, Disciplinary Actions for Consumers.
If there is no concern that the individual may have used alcohol or an illegal substance at WTC, the case manager/center counselor, WTC Addictions Specialist and Center Counseling Supervisor shall consult with the referring field counselor as soon as possible.

If the individual is receiving substance abuse support services from WTC or confirms substance abuse issues not previously acknowledged, consideration shall be given to the individual's status in recovery, and whether the individual requires an intensive treatment program for substance abuse and should be discharged or placed on leave to receive this service in the community. Continuation of services at WTC requires a team meeting, including the individual, field counselor, case manager/center counselor, Center Counseling Supervisor, WTC Addictions Specialist and other appropriate staff, and shall include development of a Substance Abuse Support Services Agreement (if not already completed) and an Addictions Action Plan spelling out expectations for substance abuse support services participation and monitoring.
If the individual states, and evidence confirms, that usage has been an aberration and not a pattern of substance abuse behavior, consultation with the WTC Addictions Specialist shall be requested, with consideration given to recommendations.

Individuals with a positive finding for alcohol or drug use who are already on an Addictions Action Plan shall have the consequences implemented.

307.06 Responsibilities

The Center Counseling Supervisor is responsible to supervise and assist the Addictions Specialist in developing and administering a coordinated program of Substance Abuse Support Services.
Behavioral Health Services Staff are responsible to:

Collect urine for drug screening. This will be done using established guidelines for urine collection and submission to the lab for testing.
Notify the case manager/center counselor of positive findings of screening tests.
Assist and coordinate with the Addictions Specialist regarding emergency referrals to detoxification units, medical facilities or community-based addictions treatment centers.

The Addictions Specialist is responsible to:

Provide support and encouragement to consumers to assist them to begin and maintain a recovery lifestyle:
Coordinate and provide the following WTC Substance Abuse Support Services:

Substance Abuse Assessments
Breathalyzer and Urine Tests
Individual Counseling (drug education)
Group Counseling
Lectures on substance abuse

Participate in development and implementation of Addictions Action Plans.

Case managers/center counselors are responsible to:

Review referral information to identify individuals who could benefit from substance abuse support services.
Provide encouragement and support to individuals to assist them to begin and maintain a recovery lifestyle.
Initiate consultation with the Addictions Specialist and/or the Center Counseling Supervisor for individuals with substance abuse or use issues not previously identified.
Initiate team meetings for individuals with substance abuse or use who relapse or who display behavior which conflicts with the success of their rehabilitation program.
Develop and implement Addictions Action Plans as needed or required in consultation with the Addictions Specialist.
Consult with field counselor/referral source regarding suspected substance abuse or use issues, especially those not identified at referral.

The Admissions staff is responsible to alert DORS Police, Center Counselor/Case Manager/Administrator, and/or the Addictions Specialist of suspicion of substance use.
The DORS Police Staff are responsible to:

Provide support to the case manager/center counselor, Addictions Specialist, and Administration in instances when an individual appears to be violent or belligerent.
Conduct room searches according to established protocol at the request of the WTC Director or designee when there is reasonable suspicion that alcohol or illegal substances may be on the premises.

All WTC Staff are responsible to report the observance of unusual behavior of an individual suggestive of alcohol and/or drug usage to the case manager/center counselor, Addictions Specialist or other appropriate staff for appropriate action.
WTC Residential and Enrichment Services staff are responsible for investigating suspicion of substance use which occurs on the evening and night shift using Suspicion of Substance Use Procedures (RS-WTC-4h).

308 WTC Center Records

308.01 Purpose

To establish procedures related to WTC Center Records.

308.02 Applicability

WTC staff, contractual employees and DORS-approved vendors.

308.03 Policy Statement

WTC staff, contractual employees, and DORS-approved vendors will comply with RSM 2, Section 200, standards of the Commission on Accreditation of Rehabilitation Facilities (CARF) for accredited departments, and DORS and WTC policies, guidelines and accepted professional standards of practices for all WTC departments.

308.04 Procedures

All WTC staff, contractual employees, and DORS-approved vendors will follow procedures set forth in RSM 2, Section 200 related to the confidentiality of consumer records.
WTC staff must enter Service Notes into the consumer's active service authorization within 24 hours for the following entries. If the information is not entered within 24 hours, then the information should be included in a Service Note with the Summary documenting the date of the actual interaction.

Information related to the rehabilitation process.
Communication with the consumer, relevant staff, and DORS field counselors related to the rehabilitation process.

To store and protect WTC Center Records, WTC has implemented the following systems and procedures:

Installed the FM-200, a chemical fire extinguisher.
In the event of water damage, the Center Records charts will be recreated using the electronic copies of reports saved in AWARE™ and from the case records of the Office of Field Services or the Office for Blindness & Vision Services.
WTC has installed Times-2 speed files at the Center Records for storage and protection of records.
In the event of fire and water emergencies/disaster at WTC, WTC Emergency Procedures (Section 600) and DORS/WTC Continuity of Operations Plan (Section 611) shall be implemented.
Center Records Office shall retain basic data for all records of service that are destroyed, which includes name of consumer and participant identification number, and the date of last discharge.

The following documentation standards ensure uniformity in documentation submitted to WTC Center Records:

The record should contain the original copies of all documents generated by WTC Staff.
The consumer’s first name, last name and participant identification (PID) number must be on each document.
All entries in the record should include the staff signature or initials and credentials.
All staff are responsible for securing the consumer’s signature on documents, as applicable. Exceptions must be noted with a reason and staff signature.
All entries in the record should include the date (month, day, year).
All handwritten entries should be legible in ink.
Abbreviations, acronyms and symbols should be used only after meaning is provided in the document except for universally-approved medical abbreviations.
When submitting documents that have been obtained after the consumer’s admission to WTC, staff should document appropriate submission to the record by initialing and dating each document.
To correct an error in the record, draw a single line through the incorrect entry, write the correction, and initial and date the correction.
All reports must document the dates of service providing the service item start date and the service item complete date on the first page of the document.
All reports must document the date of the report.
All reports must be submitted to Center Records within 14 working days of the service item complete date.
Reports that include an electronic signature received electronically from vendors who provided WTC services will be entered into the Center Record with the email documenting the sender as the vendor and the presence of the attachment.
The final Individual Service Plan (ISP) and Monthly Review meeting for Career and Technology Training services will be held prior to but within one week of class completion. This meeting will be documented on the final report by signature and date of the center counselor, instructor, and consumer. Exceptions related to the date of the final meeting must be approved in advance by the supervisor of center counseling and documented in an AWARE™ Service Note. The final report will be attached to AWARE™.

308.05 Responsibility

All WTC staff, contractual employees, and DORS-approved vendors are responsible for ensuring compliance with these standards.

309 Enrichment Services

309.01 Purpose

To establish the WTC Enrichment Services program.

309.02 Applicability

Enrichment Services staff, and WTC staff, interns, volunteers, and consumers.

309.03 Policy Statement

Enrichment Services is responsible for providing WTC- and community-based activities for consumers that assist in preparing them for employment.

309.04 Procedures

WTC Enrichment Services

Enrichment Services staff will be responsible for developing and distributing the weekly WTC Student Activity Guide with information gathered from the staff.
Enrichment Services staff will provide an orientation to the program for all new residential consumers.
Enrichment Services activities provided at WTC and in the community will have a primary focus to develop employment skills including work readiness, communication and presentation, critical thinking, leadership, interpersonal and social, and personal development.
Enrichment Services staff will receive information provided from the WTC Case Review Team meeting to identify consumers that need to focus on specific employment preparation skills.
Enrichment Services staff will contact the consumer’s case manager/center counselor and WTC Evening supervisor concerning issues during activity participation. This information will also be reported at the WTC Case Review Team meeting by staff representing Enrichment Services.

Travel Training WTC

The field counselor or case manager/center counselor will ensure when drafting or amending a service authorization for WTC training and Room, Board, & Enrichment (RB&E) residential consumers who need assistance in learning to use public transit that the service authorization will include WTC Enrichment Services/Travel Training -Individual (category/subcategory).
The AWARE™ case manager will be responsible for assigning the Enrichment Services service group and the Enrichment Services staff will be responsible for approving the item.
The assigned Enrichment Services staff will be responsible for identifying consumers for this program and entering their name as the AWARE™ service manager.
The assigned Enrichment Services staff will start the Travel Training item after the consumer begins the training.
For each travel training activity, the assigned Enrichment Services staff will email the DORS field counselor, case manager/center counselor, and additional appropriate staff informing them of the training status. This email will be copied into a Service Note.
The assigned Enrichment Services staff will be responsible for ending the Travel Training WTC item.

309.05 Responsibility

DORS field staff and WTC staff identified are responsible for implementing this policy.

310 Minors

310.01 Purpose

To establish WTC's business practices for serving individuals with disabilities that are minors (age 17 and younger).

310.02 Applicability

WTC Admissions, DORS Security, SRD Residential and Enrichment Services, and WTC Staff.

310.03 Policy Statement

In order to promote, protect and preserve the best interest, safety and security of individuals with disabilities that are minors (age 17 and younger) served at WTC, the following business practices are established.

310.04 Procedures

Admissions

AWARE™ admission letters include the following information which informs the minor that they must be accompanied by their parent or legal guardian on the day of admissions:
If you are 17 years of age or younger, then please have a parent or legal guardian stay with you during the admissions process. They will need to co-sign the Admission form.
The parent or legal guardian accompanying the minor must co-sign the Admission form.
During the admissions intake process, the Admissions staff informs the parent or legal guardian that there are security and residential staff on the premises 24 hours a day but that WTC is not a locked facility.
The minor and the parent or legal guardian are advised that minors are not allowed to go off the grounds of WTC unless with their parent, parent designee, legal guardian, or with a WTC staff person. They are also advised that WTC personnel will not approve minors to leave the WTC grounds without supervision; however, WTC staff will not prevent or block a minor from leaving.

Admissions - Supported Residence Dormitory (SRD)

The parent or legal guardian must accompany the minor to his/her room on admission day.
The parent or legal guardian is given the SRD business card which provides the SRD phone numbers.
The name of the minor is listed on the residential "white board" and the dorm room name. Both tag colors are the same denoting that the consumer is a minor.
Minors will only be assigned a roommate who is also a minor.

AWARE™

A report is run daily in AWARE™ which identifies all minors with an active service authorization. The AWARE™ Help Desk is responsible for checking the minor check box on the service authorization page in the Service Module which alerts case managers of the minor.
AWARE™ preferences can be set by AWARE™ users to identify the age of consumers in the Service Module data page header.

Security

Minors receive a picture badge from Security.
Minors who are DAY consumers have a yellow border around their picture on their ID badge. Minors who are SRD consumers have a blue border around their picture on their ID badge. They also have two red stars on their ID badges.
All minors receive a color lanyard (not the standard black) for their badge and they are informed that they need to wear the badge every day just like all adult consumers.

Daytime Core Program Hours

WTC staff monitor the activities of minors during core program hours.

If WTC staff learn that minors are planning to go into the community without WTC staff, WTC staff are to inform the minor that s/he is not permitted to leave WTC without WTC staff.
When this occurs, WTC staff will contact the center counselor/case manager to inform them of the information learned.
The center counselor/case manager and supervisor, as needed, will meet with the minor to discuss the situation and contact the minor's parent, parent designee, or legal guardian to inform them of the situation.

The center counselor/case manager shall inform the Residential and Enrichment Services supervisor to ensure continued monitoring of the minor.

All information will be relayed to the field counselor and documented in AWARE™.

Evening and Night Hours

Residential and Enrichment Services staff monitor the activities of minors when on the SRD and in the Enrichment Services areas.

If Residential and Enrichment Services staff learn that minors are planning to go into the community unescorted by parent, parent designee, legal guardian, or WTC staff, Residential and Enrichment Services staff are to inform the minor that s/he is not permitted to leave WTC without parent, parent designee, legal guardian, or WTC staff.
When this occurs, WTC staff will contact the Residential and Enrichment Services Supervisor to inform him of the information learned.
The Residential and Enrichment Services Supervisor will meet with the minor to discuss the situation and contact the minor's parent, parent designee, or legal guardian to inform them of the situation.
The Residential and Enrichment Services Supervisor will email the case manager/center counselor and copy the field counselor to inform them of the minor's plan and the status.
If Residential and Enrichment Services staff learn that the minor went into the community unescorted by parent, parent designee, legal guardian, or WTC staff, then the Residential and Enrichment Services Supervisor will attempt to contact the minor by cell phone.
If contact was made with the minor, they will be informed that they need to return to WTC immediately.
WTC will arrange for transportation to ensure the minor's safe return, if needed, via a ride-share company or a state vehicle depending on the location and issue.
The parent will be informed of the contact with the minor and the plan for their return.
The Residential and Enrichment Services Supervisor will document the situation in an email to DL WTC Communicate and the field counselor.
If contact was not made with the minor, then the Residential and Enrichment Services Supervisor will contact the parent to inform them of the situation and ask that the parent contact the minor to instruct them to return to WTC. The Residential and Enrichment Services Supervisor will request that the parent call back to inform WTC if contact was or was not made with the minor.
If contact was made with the minor:

WTC will arrange for transportation to ensure the minor's safe return, if needed, via a ride-share company or a state vehicle depending on the location and issue.
The Residential and Enrichment Services Supervisor will document the situation in an email to DL WTC Communicate and the field counselor.

If contact was not made, then the Residential and Enrichment Services Supervisor will inform the parent that 911 will be called to report a missing minor.
The Residential and Enrichment Services Supervisor will document the situation in an email to DL WTC Communicate and the field counselor.

Abuse and Neglect

WTC personnel are required to report suspected abuse or neglect of a minor to the local department of social services or to a local law enforcement agency. See Maryland Department of Human Services: Child Protective Services for local information.
Ensuring the safety of minors participating in WTC programs is an obligation shared by all citizens and organizations. WTC personnel are mandatory reporters and are required by law to report both orally and in writing any suspected child abuse or neglect.
If abuse or neglect is suspected, immediately report the suspicion to the WTC Director (or Program Manager as designee) during the day shift or supervisor during the evening or night shifts.
The WTC Director will follow agency reporting procedures to report the suspected abuse or neglect to the local department in the jurisdiction where it is believed the abuse or neglect took or is taking place.
A verbal report to the local department will be made immediately. WTC staff must complete a written report within 48 hours of contact which discloses the suspected abuse or neglect. When making a report of suspected abuse, the report must include at minimum:

The name and home address of the child and the parent or other individual responsible for the care of the child.
The present location of the child.
The age of the child (or approximate age).
Names and ages of other children in the home.
The nature and extent of injuries or sexual abuse or neglect of the child.
Any information relayed by the individual making the report of previous possible physical or sexual abuse or neglect.
Information available to the individual reporting that might aid in establishing the cause of the injury or neglect.
The identity of the individual or individuals responsible for abuse or neglect.

Reporting suspected abuse or neglect is permitted under State and federal confidentiality laws. All reports of suspected child abuse are immune from civil liability unless they are purposefully erroneous or malicious.

310.05 Responsibility

DORS and WTC staff identified in this policy are responsible for implementing this policy.
In absence of the WTC Director, a WTC Program Manager will implement this policy.
In absence of a WTC supervisor on the day shift, another WTC supervisor will implement this policy.
In absence of a WTC supervisor on the evening and night shifts, a Residential Advisor will implement this policy.

311 Medical Marijuana

311.01 Purpose

To define procedures for possession and use of medical marijuana at the WTC.

311.02 Applicability

WTC staff, consumers, volunteers, and visitors.

311.03 Policy Statement

WTC staff, consumers, volunteers, and visitors are not allowed to possess or use medical marijuana containing tetrahydrocannabinols (THC) in any form at the WTC. Any possession or use of medical marijuana containing THC at the WTC may be a cause for disciplinary action or discharge (see Section 305, Disciplinary Action for Consumers, and Section 306, Discharge of Consumers from WTC).

Medical marijuana containing tetrahydrocannabinols (THC) cannot be possessed or used on the WTC campus as it could jeopardize Maryland State Department of Education – Division of Rehabilitation Services – Workforce & Technology Center federal funding. A condition of MSDE-DORS/WTC receiving federal grant funds from the U.S. Department of Education is compliance with the Federal Drug-Free Workplace Act 41 U.S.C. §701 et. seq. As a recipient of federal funds, MSDE-DORS/WTC must make a good faith effort to maintain a drug-free workplace. 34 C.F.R. §84.200. see also, 2 C.F.R. §182.200. Failure to do so can lead to the U.S. Department of Education suspending or terminating a grant award (our funding). 34 C.F.R. §84.510.

WTC staff, consumers, volunteers, and visitors are allowed to possess and use hemp products containing cannabinol (CBD). Hemp products containing CBD do not contain THC and are not prohibited by law. However, since the WTC is a non-smoking and non-vaping campus, therefore staff, consumers, volunteers, and visitors are not allowed to smoke or vape CBD hemp products. Consumers should be encouraged to speak with their medical provider about alternatives prior to coming to the WTC to receive services.

311.04 Definitions

Cannabinoid – A group of natural or synthetic compounds, such as cannabinol or tetrahydrocannabinol, found in marijuana plants.
Cannabinol (CBD) – A non-psychoactive cannabinoid found in the hemp plant that contains less than .3% THC.
Tetrahydrocannabinol (THC) – A compound that is the physiologically active component in marijuana derived from the Indian hemp plant or produced synthetically.
Medical marijuana – Refers to using the whole, unprocessed marijuana plant or its basic extracts to treat symptoms of illness and other conditions, as permitted by Maryland Health General Article, Title 13, Subtitle 33.

311.05 Procedures

When the case manager/center counselor is informed that the consumer uses medical marijuana, then s/he will contact the consumer to discuss the consumer’s type of medical marijuana, frequency, and time of use.

TYPE: Cannabinol (CBD)

The use of non-THC hemp products containing CBD is allowed on the WTC campus.
If the consumer smokes or vapes hemp products containing CBD, then the consumer will be informed that the WTC Argonne Drive campus is a smoke-free campus. The consumer will be informed that he or she must use non-smoke CBD products. This may require that the consumer be put on leave until they have obtained an alternate option.
The frequency and time of use of non-THC hemp products containing CBD will be discussed by the case manager/center counselor with the consumer to ensure that it does not adversely affect their participation in WTC services and programs.

TYPE: Tetrahydrocannabinol (THC)

If the consumer uses medical marijuana with THC, then the consumer will be informed that it cannot be possessed or used on the WTC campus. If the consumer is unable to abstain, this may require that the consumer be placed on leave until the consumer has obtained an alternate option.
Consumers in all Career & Technology Training programs and Work Readiness Programs will be informed during the preadmission conference that the use of medical marijuana with THC is not acceptable. This includes prior to their arrival each day or during the day, whether at WTC or on an internship site. If there are instances of use or impairment, then the consumer will be placed on leave until the consumer has obtained an alternate option.
Consumers attending all other WTC services and programs will be informed during the admission process through the Admission Packet that the use of medical marijuana with THC is not acceptable.
According to businesses which are represented on the WTC Business Advisory Boards, the use of medical marijuana containing THC is not conducive to the following labor industries: automotive general service technician, automotive detailing, automotive refinishing, childcare, and warehouse. These board members representing these industries have indicated that drug testing is completed as a requirement for hiring and maintaining employment. These business advisory board members representing these industries have further indicated that the use of medical marijuana containing THC under any circumstances is not acceptable. Based on this information, consumers will be counseled to abstain, discuss the matter with their medical provider to explore alternatives, and/or or make a career change in consultation with their DORS counselor.

WTC Staff Responsibility

If it is suspected by any WTC staff person that the consumer has used medical marijuana containing THC (e.g., smell), then the WTC staff will identify the consumer and report them to their case manager/center counselor and the behavior health specialist (addiction counselor) for vocational counseling and drug screening.
If it is suspected that the use of medical marijuana containing THC is negatively impacting the consumer’s service or program, then the case manager/center counselor will schedule a team meeting to discuss with the DORS counselor, behavioral health specialist, service provider(s), center counselor supervisor, if appropriate, and consumer.
When testing positive for marijuana, the behavioral health specialist will inquire of the consumer if he or she is using medical marijuana containing THC. If the consumer states they are using medical marijuana containing THC, the behavioral health specialist will confirm with the consumer their use of medical marijuana containing THC by requesting a copy of their medical marijuana card.

Consumers who wish to explore substance-free alternatives to medical marijuana containing THC may receive brief counseling or education by the WTC behavioral health specialist (e.g. meditation, mindfulness, emotional freedom technique, etc.).
Consumers who are concerned about developing an addiction or who have already developed an addiction, can be provided brief counseling and develop a plan to reduce the risk with the WTC behavioral health specialist.

311.06 Responsibility

WTC staff are responsible for implementing this policy.
Department supervisors are responsible for administration of this policy.
WTC Program Managers and WTC Program Director are responsible for monitoring this policy.

312 Virtual Services

312.01 Purpose

To establish procedures for the provision of virtual services.

312.02 Applicability

All virtual services provided by Career & Technology Training Services.

312.03 Policy Statement

WTC will promote policies and implement procedures related to virtual service provision.

312.04 Procedures

Referral
The case manager will identify consumers who have been referred for a virtual service using AWARE™. The referral will be reviewed for the appropriateness of the type of service (AWARE™ service item). The case manager will follow the current business practice of the department for contacting the referred consumer, completing a virtual service prescreening with the consumer to ensure they have in their possession all the necessary technology and/or equipment for the duration of the service, and that they agree to participate in the virtual service.
Scheduling
If the consumer is appropriate for the virtual service, the case manager will follow the current business practice of the department for scheduling the consumer and informing the DORS counselor of the scheduled service. A staff person, assigned by the department, will meet with the consumer virtually to ensure that they are able to use all the necessary technology and/or equipment for the service. If the consumer needs accommodations that cannot be provided virtually, needs hardware/software accommodations, or needs in-person services, then the virtual service will not be provided and in-person services will be scheduled.
Service Provision

The department supervisor will ensure that staff assigned to provide the virtual service will receive documented competency-based training, if needed, on the computer software, hardware, and equipment to be used during the virtual service provision.
The staff person assigned to provide the virtual service will provide instruction to the consumer in utilizing the computer software, hardware, and equipment, as appropriate.
Prior to the start of each session, all consumers and staff in the session are identified and the staff provides relevant information regarding the session.
Audio and/or video recording and photography is prohibited during the virtual service.
When an emergency occurs during the virtual service provision, if another person at the virtual site is not available to assist, the WTC service provider will call 911 and remain on the phone with the 911 operator until directed to end the call. The WTC service provider will use the AWARE™ Intake page to make contact with the consumer’s listed emergency contact. Documentation of the incident will follow current WTC practice. Follow-up with the consumer and/or emergency contact will be completed to ascertain consumer status.

Service Documentation
Current business practice of the department for documenting the service provision or other issues, which occurred during the virtual service, will be followed.
Equipment Maintenance
All computer hardware and headsets will be maintained in accordance with manufacturers’ recommendations by the agency’s information technology department.

312.05 Responsibilities

The WTC Program Director is responsible for the administration of this policy.
The WTC Leadership Team is responsible for the oversight of this policy.
The Career & Technology Training Services supervisor is responsible for implementation of this policy.

313 Medication Support for WTC Residential Consumers

313.01 Purpose

To establish a policy and procedure to address medication support for WTC residential consumers.

313.02 Applicability

This policy applies to WTC consumers who take medication while residing in the WTC dormitory.

313.03 Policy Statement

Consumer possession of and adherence to medication is regarded as a contributing factor for maintenance of optimal health and wellness while receiving WTC services which contributes to optimizing successful vocational outcomes. WTC staff will follow medication support procedures for WTC residential consumers.

Consumers who reside in the dormitory must be able to self-administer their medication. Consumers who reside in the dormitory need to bring their medication with them. Consumers must bring enough medication for each week. WTC residential staff cannot store nor administer medication when a consumer is scheduled to take it.

313.04 Procedures

The WTC residential staff are available to provide support to residential consumers related to taking their medication. This support will include providing consumers with reminders to take their medicine at their designated time, ensuring residential consumers bring their pillbox to the medication support desk, ensuring that residential consumers are retrieving their medications from the appropriate day/time slot on their pillbox, and/or prompting residential consumers to contact their family if they are running out of medication before the end of the week.

Medication is a very important part of the consumer's health and success. If the consumer does not bring medication or runs out, the residential supervisor or designee will inform the center counselor/case manager who will follow-up with the consumer and family to discuss the issue and determine an appropriate course of action. This could include but is not limited to: consumer skipping a dose or doses, having someone bring medication to them, going to a pharmacy to pick it up, or going home until they can get more.

Scheduling Process:

When scheduling residential consumers, the center counselor/case manager will identify if the consumer will be taking medication while residing in the dormitory.
During the scheduling process, the consumer will receive an orientation to the medication support process by the center counselor/case manager and have the opportunity to ask questions.

The consumer will be informed that all consumers need to report to residential staff when taking their medication with their pillbox and will be observed removing pills from the correct day/time slot.
The case manager/center counselor will inform the consumer and/or family that it is recommended that the consumer bring a daily medication cassette (pillbox) from home filled with medication for each day of the week. If they do not have one, then WTC will give the consumer one to use.

Once a consumer is scheduled for services, the residential staff will be informed and provided with the consumer's move-in date by the center counselor/case manager.
The email will include the time/times that the consumer takes medication.

Admission Process:

On arrival at the SRD, the residential staff will orient the consumer to the medication support process and provide a medication cassette (pillbox), if needed.
The consumer and/or consumer's family will be asked to confirm the time the consumer takes their medication, and this information will be documented on the Medication Support form.

Medication Support Procedures:

The medication support process will be provided at the target medication times reported by the consumer and/or their family.
Each time that a consumer should take their medication, they must report to the medication support desk with their pillbox and something to drink.
Each time that a consumer takes medication, the residential supervisor or designee will observe the consumer taking their medication to ensure that they choose the correct day/time slot.
After the consumer has taken their medication, the residential supervisor or designee will document it on the daily Medication Support form by signing their initials and having the consumer also initial the form.
When a consumer refuses to take medication, does not report to take medication, or reports that they took their medication without the residential supervisor or designee observing them, the WTC residential staff will document the issue and email the DORS counselor and other appropriate team members using the DL WTC Communicate list for follow-up. The email will be copied into an AWARE™ service note.

313.05 Responsibility

The WTC Administrative Services Program Manager has an overall responsibility to assure staff adhere to this policy and implement the procedures.
The WTC Residential Services supervisors or designee are responsible for adhering to this policy and implementing the procedures.
Case managers/center counselors and the residential staff are responsible for adhering to this policy and implementing the procedures.

314 Procedures for Using Breathalyzer Equipment

314.01 Purpose

To define procedures for the use of the breathalyzer with WTC consumers.

314.02 Applicability

All WTC staff and consumers.

314.03 Policy Statement

A breathalyzer test will be administered to WTC consumers when there is suspicion of alcohol consumption, which has or may affect the consumer’s health and their ability to function safely.

314.04 Definitions

Signs and symptoms of alcohol intoxication and poisoning are observable signs that are changes to a person’s reactions, inhibitions, physical appearance, coordination, and judgement.

Signs and symptoms of alcohol intoxication:

Behavior problems
Impaired attention or memory
Impaired coordination
Impaired judgement
Mental changes
Red or glossy eyes
Slurred speech
Smells of alcohol
Uncharacteristic inappropriate behavior
Unstable moods
Vomiting

Signs and symptoms of alcohol poisoning:

Blue tinged or pale skin
Confusion
Irregular breathing (a gap of more than 10 seconds between breaths)
Low body temperature
Passing out and cannot be awakened
Seizures
Slow breathing (less than 8 breaths a minute)
Vomiting with additional signs and symptoms of alcohol poisoning

314.05 Procedures

Breathalyzer

Breathalyzers are located in Behavioral Health Services and the Residential Services.
Any WTC staff person can administer the breathalyzer test as long as there is justification for the need to test the consumer.

Consumer Under the Legal Drinking Age (20 years or younger)

The following observations will result in a consumer, under the legal drinking age, being administered a breathalyzer test:

Displaying signs and symptoms (see Definitions) of alcohol intoxication.
Admits to recently consuming alcohol.
Observing alcohol consumption on the WTC grounds or at WTC activities.
Locating alcohol containers in their possession.
Locating alcohol containers or smells of alcohol inside the SRD room.

Observation of signs and symptoms of alcohol poisoning will result in a 911 call.

Consumer Above the Legal Drinking Age (21 years or older)

The following observations will result in a consumer, above the legal drinking age, being administered a breathalyzer test:

Admits to recently consuming alcohol on the WTC grounds or at WTC activities.
Observing alcohol consumption on the WTC grounds or at WTC activities.
Displaying signs and symptoms (see Definitions) of alcohol intoxication during their participation in WTC activities, services, and programs.

Observation of signs and symptoms of alcohol poisoning will result in a 911 call.

Breathalyzer Administration

The breathalyzer equipment will come with instructions on how to properly administer the test.
Administering the Test – general directions:

Attach a mouthpiece to the breathalyzer.
Press and release the power button.
Wait for the unit to warm up to optimal test conditions until the display shows "blow".
Have the consumer blow into the mouthpiece for approximately five seconds. As the consumer starts to blow, you will hear a long, steady beep. Tell the consumer that they must not stop blowing until this beep stops.
If there is no breath sample blown within 15 seconds, the display will show "OUT". Press start to restart the countdown cycle and retest.
Wait a few moments for the device to analyze the breath sample.
The test result will be displayed for approximately 15 seconds. Record the numerical result.
If you want to perform another test, wait for the backlight to turn off, and then tap the power button.
The breathalyzer will automatically shut off within two minutes if not in use.

Testing Issues

If you see "Flow" or "flo" in the display, the breath sample was either not strong enough, or more likely, not long enough. The consumer must provide a strong and steady breath sample and must not stop blowing until you hear the long beep indicator stop.
If you see "bat" in the display, the battery power is low. Please replace the batteries.

Breathalyzer Results & Next Steps
Any test result higher than 0.01% will be addressed as follows:

Health & Safety

If staff have concerns about the consumer’s medical stability and/or safety based on observed signs and symptoms, then they will arrange for the day or residential consumer to rest in a dorm room until the consumer tests 0.01% or lower. Residential staff will check on the consumer regularly. Day consumers will be allowed to exit to home at that time.
If staff have concerns about the consumer’s medical stability based on observed signs and symptoms, then they will call 911.

Staff will follow the protocol for contacting the consumer’s emergency contact(s) when sending a consumer to the hospital.

Consequences – In all situations, a team meeting will be scheduled to discuss the situation, develop a plan, and identify consequences, as appropriate.

Any possession or consumption of alcoholic beverages or food (e.g., jello shots) is prohibited on the WTC grounds or at WTC activities and may be a cause for disciplinary action or discharge. See Section 305, Disciplinary Action for Consumers, Section 306, Discharge of Consumers from WTC, and the WTC Admissions Packet/Consumer Expectations.

Breathalyzer Results & Documentation
Results will be documented in an email to the consumer’s field counselor by the consumer’s center counselor/case manager. When the test is administered by Residential Services staff on the evening or night shifts, the Residential staff will email both the field counselor and the center counselor/case manager. Other appropriate staff will be copied on the email. The email will include justification on why the test was administered, including all observed behaviors, and the current health status of the consumer regarding intoxication. The email will be copied into an AWARE™ Service Note.

Incident Report
An Incident Report will be completed when observed behaviors cause harm to the consumer or others, a 911 emergency call is placed, possession or use of substances on the WTC grounds occurred, and/or use by consumers under the legal drinking age occurred.
Residential and Enrichment Services Procedures for Suspicion of Substance Use – Evening and Night Shifts
When a consumer is suspected of being impaired due to suspected alcohol use, then the procedures outlined on the Suspicion of Substance Use form (RS-WTC-7e) will be followed by evening and night shift residential staff.

314.06 Responsibility

The WTC Program Director has overall responsibility to assure staff adhere to this policy and implement the procedures.
The WTC Center Counselor Supervisor and appropriate department Supervisors are responsible for implementing this policy and compliance with its provisions on the day shift.
The WTC Residential Services Evening Administrator, Residential & Enrichment Services Evening Supervisor, and Residential Night Supervisor are responsible for implementing this policy and compliance with its provisions on the evening and night shifts.
The Risk Manager will ensure a thorough investigation of the reported situation following the Risk Management policy
Center Counselors, Case Managers, and the Residential staff are responsible for implementing these procedures.

​​​​​​​RSM 6: Workforce & Technology Center

Section 300