1923.2 Diluted Samples Obtained During Testing
CPS June 2010
A diluted sample indicates that a client drank a large amount of water at some time before the drug test.
When the lab indicates that a sample is diluted, the caseworker can take one the following actions to arrive at a conclusion about the client's use:
• Have the client retested
• Request a different type of testing, such as requesting a hair follicle test instead of a urine test
• Rely on credible evidence obtained through observation, information from collateral sources (such as a teacher, neighbor, or family doctor), and the case history
1923.3 Instant (Swab) Tests and Court Hearings
CPS June 2010
An instant test is a swabbing of a client's oral fluids. The test is performed by a caseworker to test for recent drug use. If possible, the test results are confirmed by a laboratory.
Using the Tests in Court
Before presenting the results of instant swab tests as evidence in court, the caseworker mustobtain confirmation from a laboratory.
1923.4 Using Acceptable Contractors to Obtain Test Results
CPS June 2010
DFPS accepts lab test results from physicians, hospitals, the legal system (such as the adult probation department), and providers of substance abuse treatment in order to assess safety and to assess the need for services and treatment.
1923.5 Frequency of Random Substance Abuse Testing
CPS June 2010
In general, the caseworker may conduct random drug tests when substance abuse laboratory testing is allowed under 1920Substance Abuse Testing; that is, when:
• a case is scheduled for closure;
• reunification of the child with his or her family is contemplated;
• there are changes in the parent's appearance, behavior, or affect;
• new information is received about possible substance abuse;
• the client has terminated substance abuse treatment;
• the client shows signs of returning to seeking and using drugs, including associating with former friends and family members who use drugs; keeping drug paraphernalia in the home; or making statements minimizing or denying having a problem with drugs or alcohol;
• the client refuses to create a relapse safety plan (see 1966Developing a Safety Plan in Case a Client Relapses);
• the client minimizes or denies seeking and using drugs seeking and after test results come back positive;
• there are signs that abstinence is being threatened; for example, when a client increases the amount of alcohol consumed or begins to smoke cigarettes frequently to relieve anxiety;
• the client has made minimal or no effort to mitigate the substance abuse related problems that led to abuse and neglect;
• the client is not involved in substance abuse treatment or aftercare, even though it was recommended; and
• the regional substance abuse specialist recommends testing.
Hair Follicle Testing
The caseworker determines the frequency with which random hair follicle testing may be conducted, by following regional protocols.
1923.6 Situations Not Appropriate for Drug Testing
CPS June 2010
It is not appropriate for a caseworker to arrange for drug testing when a parent is:
• actively involved in substance abuse treatment and the treatment provider conducts random testing that is based on laboratory confirmation.
• randomly tested by another entity, such as a probation department or drug court, and the test is confirmed by a laboratory. The caseworker must check into the frequency of testing by the other entity, before random testing is discontinued by CPS.
1923.7 Discontinuing Drug Testing
CPS June 2010
The caseworker must discuss with the supervisor and the client's treatment provider when contemplating discontinuing routine drug testing.
The discontinuation or modification of routine drug testing may be considered when:
• A parent does not exhibit substance seeking and using behaviors (for example, when associating with former friends or family members who use drugs; keeping drug paraphernalia in the home; or making statements minimizing or denying having a problem with drugs or alcohol); and
• The parent has a consistent pattern of negative tests results.
1923.8 Assessing Test Results or Accepting an Admission
CPS June 2010
Positive Result
The caseworker must assess a positive drug test result in relationship to the child's safety and risk. The result must be discussed with the parent in a timely manner.
If a parent with a positive drug result is not engaged in substance abuse treatment and is actively parenting a child, the caseworker refers the parent to:
• a provider of outreach, screening, assessment, and referral (OSAR) services or
• a provider of substance abuse treatment.
The threshold that makes a referral appropriate is based on the definition of a child not being safe. That is, a child is not safe when:
• threats or dangers exist in the family that are related to substance use;
• the child is vulnerable to such threats; and
• the parent who is using substances does not have sufficient protective capacities to manage or control threats.
Client Admission
A client's verbal or written admission is accepted as a positive result of drug use; however good casework practice calls for getting the client to sign a statement of use.
Testing to Rule Out Under-Reporting
If a client admits to drug use, is not engaged in treatment, and is actively parenting children, the caseworker may consider referring the client to a substance abuse provider for screening, assessment, or treatment.
Referral may be necessary because clients sometimes under-report drug use or do not admit to all of the substances that they have used.
Clients likewise may under-report:
• the frequency with which they use dugs,
• the quantity of drugs they use, and
• the amount of money they spend on the drugs.
Negative Result
When the result of a parent's drug test is negative, the caseworker:
• notifies the parent about the result in a timely manner; and
• encourages the parent's abstinence and provides positive feedback.
Refusal to Test
When testing is appropriate under1920 Substance Abuse Testing, but the client refuses to take a drug test, the caseworker must document the refusal to be tested.
If a parent refuses to take a drug test or refuses to allow a child who is an alleged perpetrator to be tested, the caseworker consults with the supervisor in a staffing meeting. The supervisor may recommend legal intervention, if the evidence raises concern for the child's safety.
For cases under court jurisdiction, the caseworker must notify the judge and attorneys about the client's refusal to test.
1923.9 Documenting Prescribed Medicine Before Offering Drug Testing
CPS June 2010
When testing is appropriate under 1920 Substance Abuse Testing, the caseworker must document any prescribed medication that the client is taking.
The documentation may be made by:
• completing a regional form; or
• entering the details in theContact Narrativein the IMPACT system.
The caseworker must share the information about the client's medication with the lab's medical review officer (MRO).
1924 Special Situations Related to Substance Abuse
1924.1 Methadone and Prescription Medication
CPS June 2010
Methadone
If the parent tests positive for methadone, the caseworker:
• obtains a release (Form 2062Word DocumentDFPS Release of Confidential Information to DSHS/Substance Abuse Services) from the parent;
• verifies with the methadone clinic, that the parent has a prescription for methadone and is taking methadone as prescribed; and
• assesses the effect that the methadone dosage has on the parent's ability to provide consistent and safe supervision of the children.
Prescription Medicine
Similar to methadone, the caseworker must assess the effect that prescription medications have on a parent's ability to provide supervision and to keep children safe.
To determine whether the client is taking his or her medication as prescribed, the caseworker must check with the client's medical provider.
For the caseworker to obtain the information from the medical provider, the client needs to sign a consent-to-release form (Form 2062Word DocumentDFPS Release of Confidential Information to DSHS/Substance Abuse Services).
If the client refuses to sign the release form, the caseworker consults with the supervisor about whether to request legal intervention.
http://www.dfps.state.tx.us/handbooks/CPS/Files/CPS_pg_1923.asp
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CPS June 2010
A diluted sample indicates that a client drank a large amount of water at some time before the drug test.
When the lab indicates that a sample is diluted, the caseworker can take one the following actions to arrive at a conclusion about the client's use:
• Have the client retested
• Request a different type of testing, such as requesting a hair follicle test instead of a urine test
• Rely on credible evidence obtained through observation, information from collateral sources (such as a teacher, neighbor, or family doctor), and the case history
1923.3 Instant (Swab) Tests and Court Hearings
CPS June 2010
An instant test is a swabbing of a client's oral fluids. The test is performed by a caseworker to test for recent drug use. If possible, the test results are confirmed by a laboratory.
Using the Tests in Court
Before presenting the results of instant swab tests as evidence in court, the caseworker mustobtain confirmation from a laboratory.
1923.4 Using Acceptable Contractors to Obtain Test Results
CPS June 2010
DFPS accepts lab test results from physicians, hospitals, the legal system (such as the adult probation department), and providers of substance abuse treatment in order to assess safety and to assess the need for services and treatment.
1923.5 Frequency of Random Substance Abuse Testing
CPS June 2010
In general, the caseworker may conduct random drug tests when substance abuse laboratory testing is allowed under 1920Substance Abuse Testing; that is, when:
• a case is scheduled for closure;
• reunification of the child with his or her family is contemplated;
• there are changes in the parent's appearance, behavior, or affect;
• new information is received about possible substance abuse;
• the client has terminated substance abuse treatment;
• the client shows signs of returning to seeking and using drugs, including associating with former friends and family members who use drugs; keeping drug paraphernalia in the home; or making statements minimizing or denying having a problem with drugs or alcohol;
• the client refuses to create a relapse safety plan (see 1966Developing a Safety Plan in Case a Client Relapses);
• the client minimizes or denies seeking and using drugs seeking and after test results come back positive;
• there are signs that abstinence is being threatened; for example, when a client increases the amount of alcohol consumed or begins to smoke cigarettes frequently to relieve anxiety;
• the client has made minimal or no effort to mitigate the substance abuse related problems that led to abuse and neglect;
• the client is not involved in substance abuse treatment or aftercare, even though it was recommended; and
• the regional substance abuse specialist recommends testing.
Hair Follicle Testing
The caseworker determines the frequency with which random hair follicle testing may be conducted, by following regional protocols.
1923.6 Situations Not Appropriate for Drug Testing
CPS June 2010
It is not appropriate for a caseworker to arrange for drug testing when a parent is:
• actively involved in substance abuse treatment and the treatment provider conducts random testing that is based on laboratory confirmation.
• randomly tested by another entity, such as a probation department or drug court, and the test is confirmed by a laboratory. The caseworker must check into the frequency of testing by the other entity, before random testing is discontinued by CPS.
1923.7 Discontinuing Drug Testing
CPS June 2010
The caseworker must discuss with the supervisor and the client's treatment provider when contemplating discontinuing routine drug testing.
The discontinuation or modification of routine drug testing may be considered when:
• A parent does not exhibit substance seeking and using behaviors (for example, when associating with former friends or family members who use drugs; keeping drug paraphernalia in the home; or making statements minimizing or denying having a problem with drugs or alcohol); and
• The parent has a consistent pattern of negative tests results.
1923.8 Assessing Test Results or Accepting an Admission
CPS June 2010
Positive Result
The caseworker must assess a positive drug test result in relationship to the child's safety and risk. The result must be discussed with the parent in a timely manner.
If a parent with a positive drug result is not engaged in substance abuse treatment and is actively parenting a child, the caseworker refers the parent to:
• a provider of outreach, screening, assessment, and referral (OSAR) services or
• a provider of substance abuse treatment.
The threshold that makes a referral appropriate is based on the definition of a child not being safe. That is, a child is not safe when:
• threats or dangers exist in the family that are related to substance use;
• the child is vulnerable to such threats; and
• the parent who is using substances does not have sufficient protective capacities to manage or control threats.
Client Admission
A client's verbal or written admission is accepted as a positive result of drug use; however good casework practice calls for getting the client to sign a statement of use.
Testing to Rule Out Under-Reporting
If a client admits to drug use, is not engaged in treatment, and is actively parenting children, the caseworker may consider referring the client to a substance abuse provider for screening, assessment, or treatment.
Referral may be necessary because clients sometimes under-report drug use or do not admit to all of the substances that they have used.
Clients likewise may under-report:
• the frequency with which they use dugs,
• the quantity of drugs they use, and
• the amount of money they spend on the drugs.
Negative Result
When the result of a parent's drug test is negative, the caseworker:
• notifies the parent about the result in a timely manner; and
• encourages the parent's abstinence and provides positive feedback.
Refusal to Test
When testing is appropriate under1920 Substance Abuse Testing, but the client refuses to take a drug test, the caseworker must document the refusal to be tested.
If a parent refuses to take a drug test or refuses to allow a child who is an alleged perpetrator to be tested, the caseworker consults with the supervisor in a staffing meeting. The supervisor may recommend legal intervention, if the evidence raises concern for the child's safety.
For cases under court jurisdiction, the caseworker must notify the judge and attorneys about the client's refusal to test.
1923.9 Documenting Prescribed Medicine Before Offering Drug Testing
CPS June 2010
When testing is appropriate under 1920 Substance Abuse Testing, the caseworker must document any prescribed medication that the client is taking.
The documentation may be made by:
• completing a regional form; or
• entering the details in theContact Narrativein the IMPACT system.
The caseworker must share the information about the client's medication with the lab's medical review officer (MRO).
1924 Special Situations Related to Substance Abuse
1924.1 Methadone and Prescription Medication
CPS June 2010
Methadone
If the parent tests positive for methadone, the caseworker:
• obtains a release (Form 2062Word DocumentDFPS Release of Confidential Information to DSHS/Substance Abuse Services) from the parent;
• verifies with the methadone clinic, that the parent has a prescription for methadone and is taking methadone as prescribed; and
• assesses the effect that the methadone dosage has on the parent's ability to provide consistent and safe supervision of the children.
Prescription Medicine
Similar to methadone, the caseworker must assess the effect that prescription medications have on a parent's ability to provide supervision and to keep children safe.
To determine whether the client is taking his or her medication as prescribed, the caseworker must check with the client's medical provider.
For the caseworker to obtain the information from the medical provider, the client needs to sign a consent-to-release form (Form 2062Word DocumentDFPS Release of Confidential Information to DSHS/Substance Abuse Services).
If the client refuses to sign the release form, the caseworker consults with the supervisor about whether to request legal intervention.
http://www.dfps.state.tx.us/handbooks/CPS/Files/CPS_pg_1923.asp
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